Individual provider · Type 1 NPI

Kathleen Ellis, PhD, LADC, LPC

Addiction (Substance Use Disorder) Counselor · New London, CT

NPI number 1679902316 Active

Practice location

365 Montauk Ave
New London, CT 06320-4700

Fax (860) 444-5107

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X000903 (CT)
Professional Counselor 101YP2500X002541 (CT)

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

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About NPI 1679902316

Kathleen Ellis, PhD, LADC, LPC's National Provider Identifier is 1679902316, issued on Nov 4, 2013. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in New London, CT. The record was last updated on Sep 10, 2025.