Individual
JAMES ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MFT, LADAC
Contact information
Practice address
2705 OAK LN, VAN BUREN, AR 72956-4816
(479) 474-8084
Mailing address
2705 OAK LN, VAN BUREN, AR 72956-4816
(479) 474-8084
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
00581-LC
NV
101YA0400X
Addiction (Substance Use Disorder) Counselor
443L
AR
106H00000X
Marriage & Family Therapist
2637
NV
106H00000X
Marriage & Family Therapist
Primary
M2210002
AR
Other
Enumeration date
08/05/2016
Last updated
10/26/2022
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