Individual
BENJAMIN ELLENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
778 W FRONTAGE RD STE 113, NORTHFIELD, IL 60093-1209
(773) 412-5260
Mailing address
5002 N WESTERN AVE APT 3N, CHICAGO, IL 60625-8440
(701) 799-9568
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/07/2022
Last updated
08/07/2022
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