Individual
ANDREW DELWYN ELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LMFT
Contact information
Practice address
1445 WAMPANOAG TRAIL UNIT 202, RIVERSIDE, RI 02915
(401) 437-4116
(401) 433-0367
Mailing address
334 BROADWAY, PROVIDENCE, RI 02909-1102
(401) 996-7886
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AE83731
—
RI
Enumeration date
09/08/2008
Last updated
11/08/2023
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