Individual
JENNIFER LYNN ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1033 BALDY MOUNTAIN RD, SANDPOINT, ID 83864-9202
(208) 920-5151
Mailing address
1033 BALDY MOUNTAIN RD, SANDPOINT, ID 83864-9202
(208) 920-5151
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC-10373
ID
101YM0800X
Mental Health Counselor
LPC-10373
ID
101YP2500X
Professional Counselor
LPC-10373
ID
Other
Enumeration date
05/14/2024
Last updated
04/16/2025
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