Individual
MS. ALISSA KATHLEEN ELLSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3500 ELLINGTON ST, CHARLOTTE, NC 28211-1102
(704) 336-7456
(704) 336-2423
Mailing address
3500 ELLINGTON ST, CHARLOTTE, NC 28211-1102
(704) 336-7456
(704) 336-2423
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C008090
NC
Other
Enumeration date
07/31/2013
Last updated
07/31/2013
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