Individual
CHRISTINE ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
4300 MARSH LANDING BLVD STE 204, JACKSONVILLE BEACH, FL 32250-1420
(904) 515-2050
Mailing address
1015 ATLANTIC BLVD STE 161, ATLANTIC BEACH, FL 32233-3313
(904) 515-2050
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH13237
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MH13237
STATE OF FLORIDA
FL
Enumeration date
06/03/2015
Last updated
02/05/2021
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