Individual
JACQUELINE ELLIS
Active
Individual
JACQUELINE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-C
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
28071
MD
1041C0700X
Clinical Social Worker
0904017476
VA
1041C0700X
Clinical Social Worker
Primary
28071
MD
Other
Enumeration date
12/05/2021
Last updated
02/06/2026
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