Individual
MRS. DAWN ELAINE ELLICOTT CLINKSCALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
4700 N STATE ROAD 7, LAUDERDALE LAKES, FL 33319-5800
(954) 634-8096
Mailing address
4740 N STATE ROAD 7, LAUDERDALE LAKES, FL 33319-5839
(954) 486-4005
(954) 497-3857
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MT3549
FL
1041C0700X
Clinical Social Worker
Primary
MT3549
FL
106H00000X
Marriage & Family Therapist
MFTMFT00221521
KY
Other
Enumeration date
09/16/2015
Last updated
04/08/2019
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