Individual
RACHEL ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, SAC-IT
Contact information
Practice address
1015 GAMMON LN, MADISON, WI 53719-2210
(608) 417-8162
Mailing address
1015 GAMMON LN, MADISON, WI 53719-2210
(608) 417-8162
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
WI
104100000X
Social Worker
11565-123
WI
104100000X
Social Worker
Primary
—
WI
Other
Enumeration date
05/19/2022
Last updated
02/08/2024
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