Individual
BRIANNA ELLINGWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC-D
Contact information
Practice address
5708 S BAY RD, CICERO, NY 13039-8652
(315) 207-4803
Mailing address
141 MALVERNE DR, SYRACUSE, NY 13208-2349
(315) 207-4803
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
010330
NY
Other
Enumeration date
03/19/2020
Last updated
03/17/2026
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