Individual provider · Type 1 NPI

Lisa Ellisbello

Addiction (Substance Use Disorder) Counselor · San Rafael, CA

NPI number 1447798566 Active

Practice location

1477 Lincoln Ave
San Rafael, CA 94901-2028

Call (415) 459-2395 Map

Mailing address

1477 Lincoln Avenue
San Rafael, CA 94903

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1447798566

Lisa Ellisbello's National Provider Identifier is 1447798566, issued on Feb 9, 2017. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in San Rafael, CA. The record was last updated on Feb 9, 2017.