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Individual
EMILIE ANN ELLENBERG
Active
Individual
EMILIE ANN ELLENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH13313
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014668600
—
FL
01
—
5796
FLORIDA CERTIFICATION BOARD - CAP - ADDICTION PROFRESSIONAL
FL
01
—
MH13313
STATE OF FLORIDA - DEPT OF HEALTH
FL
Enumeration date
04/06/2015
Last updated
08/28/2019
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