Individual provider · Type 1 NPI

Ellen Louise Kornetsky, M.S.W., L.C.S.W.

Mental Health Counselor · Portland, ME

NPI number 1972822211 Active

Practice location

75 Washington Ave
Portland, ME 04101-2665

Fax (207) 761-0748

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XLC5740 (ME)

Mental Health Counselor: Definition to come...

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About NPI 1972822211

Ellen Louise Kornetsky, M.S.W., L.C.S.W.'s National Provider Identifier is 1972822211, issued on May 26, 2010. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Portland, ME. The record was last updated on May 26, 2010.