Individual
JILL DIANE ELLINWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LCSW, LPC
Contact information
Practice address
505 BROADWAY ST, BARABOO, WI 53913-2183
(608) 355-4214
Mailing address
S5789 S SHORE RD, BARABOO, WI 53913-9235
(608) 356-7039
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
647-125
WI
1041C0700X
Clinical Social Worker
1197-123
WI
Other
Enumeration date
03/13/2007
Last updated
09/11/2025
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