Individual
MR. MARK DAVID ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
2440 6TH ST, EUREKA, CA 95501-0788
(707) 268-2800
Mailing address
PO BOX 4198, ARCATA, CA 95518-4198
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
10276
CA
101YM0800X
Mental Health Counselor
PCCI4283
CA
101YP2500X
Professional Counselor
Primary
10276
CA
Other
Enumeration date
12/04/2017
Last updated
10/01/2021
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