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Individual
MR. CHARLES ELLIS
Active
Individual
MR. CHARLES ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW-C
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
26960
MD
1041C0700X
Clinical Social Worker
5980-C
NV
1041C0700X
Clinical Social Worker
Primary
LCS 19143
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982975009
—
NV
Enumeration date
10/16/2006
Last updated
10/09/2024
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