Individual
MS. JOSEPHINE ANNE ELLSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
811 MAVERICK LANE, BENSON, AZ 85602
(520) 548-2929
Mailing address
811 MAVERICK LANE, BENSON, AZ 85602
(520) 548-2929
(520) 586-3758
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
264199
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2541
LPC
AZ
01
—
264199
NBCC
AZ
Enumeration date
09/27/2011
Last updated
09/27/2011
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