NPI 1164174645

Anthony Ellie, LPCNBCCMA

Practitioner Professional Counselor Plymouth, WI

Practice location

Address: 2209 Eastern Ave, Plymouth, WI 53073-4281
Phone: (920) 892-7606
Fax: (920) 449-4247

Registered specialties

Professional Counselor Primary

Behavioral Health & Social Service Providers Taxonomy 101YP2500X Licence 10475-125 (WI)

Other Counselor providers in Wisconsin →

Registry record

NPI: 1164174645
Entity type: Individual
Sex (as registered): Male
NPI issued: 25 Jan 2022
Record last updated: 15 Jun 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.