Individual
JAMIE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191-6600
(702) 653-2273
Mailing address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191-6600
(702) 653-2273
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
8320-C
NV
1041C0700X
Clinical Social Worker
4057C
AL
1041C0700X
Clinical Social Worker
CSW005289
GA
Other
Enumeration date
11/17/2014
Last updated
05/09/2023
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