Individual
JASON ELLWEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LPC
Contact information
Practice address
910 W HAVENS AVE, MITCHELL, SD 57301-3831
(605) 996-9686
Mailing address
910 W HAVENS AVE, MITCHELL, SD 57301-3831
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LPC20212
SD
101YM0800X
Mental Health Counselor
Primary
LPC20212
SD
Other
Enumeration date
05/26/2017
Last updated
05/26/2017
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