Individual
CATHERINE C. ELLYSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
95 EXCHANGE ST, SUITE 100, PORTLAND, ME 04101-5037
(207) 871-1000
(207) 773-0472
Mailing address
45 A ST, 2W, S PORTLAND, ME 04106-2872
(207) 899-9844
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
068-0000646
VT
101YP2500X
Professional Counselor
CC3038
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100196
ANTHEM
ME
Enumeration date
06/15/2006
Last updated
09/11/2025
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