Individual
MS. LISA ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSCSW
Contact information
Practice address
3601 SW 29TH ST, STE 108, TOPEKA, KS 66614-2015
(785) 271-6551
(785) 271-6553
Mailing address
3601 SW 29TH ST, STE 108, TOPEKA, KS 66614-2015
(785) 271-6551
(785) 271-6553
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4031
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110661007
MEDICARE PTAN
KS
05
—
200613480B
—
KS
Enumeration date
06/25/2009
Last updated
11/21/2016
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