# JASON DEAN ELLIS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1720786031
- **Gender:** Man
- **Credential:** LMFT

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | LMFT15837 | AZ | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | OTC13694 | AZ | Yes |

## Other

- **Enumeration date:** 02/16/2023
- **Last updated:** 05/07/2025