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Organization
TERESA ELLSWORTH, LCSW
Active
Organization
TERESA ELLSWORTH, LCSW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA ELLSWORTH LCSW (OWNER)
(734) 673-3075
Entity
Organization
Contact information
Practice address
2219 HARBOR LAKE DR, FLEMING ISLAND, FL 32003-7796
(734) 673-3075
(904) 375-8347
Mailing address
2219 HARBOR LAKE DR, FLEMING ISLAND, FL 32003-7796
(734) 673-3075
(904) 375-8347
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
01/14/2019
Last updated
01/14/2019
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