Individual
CHANTALLE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPCC
Contact information
Practice address
107 W MAIN AVE STE 225, BISMARCK, ND 58501-3873
(701) 751-4122
(701) 751-1728
Mailing address
107 W MAIN AVE STE 225, BISMARCK, ND 58501-3873
(701) 751-4122
(701) 751-1728
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
933-1-1-18-395
ND
Other
Enumeration date
01/17/2018
Last updated
10/29/2020
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