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Individual
DR. KATHLEEN ELLIS
Active
Individual
DR. KATHLEEN ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, LADC, LPC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000903
CT
101YP2500X
Professional Counselor
002541
CT
Other
Enumeration date
11/04/2013
Last updated
09/10/2025
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