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Individual
MR. DALE D ELLENS
Active
Individual
MR. DALE D ELLENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC LMFT QMHP
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LPC#807
SD
106H00000X
Marriage & Family Therapist
LMFT#00134
IA
106H00000X
Marriage & Family Therapist
Primary
LMFT#1095
SD
Other
Enumeration date
08/10/2005
Last updated
07/13/2026
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