Individual
MATTHEW ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BA, LADC
Contact information
Practice address
2217 NICOLLET AVE, MINNEAPOLIS, MN 55404-3382
(612) 294-9263
(612) 870-3796
Mailing address
2217 NICOLLET AVE, MINNEAPOLIS, MN 55404-3382
(612) 767-0309
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
305037
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
305037
—
MN
Enumeration date
07/14/2022
Last updated
05/17/2026
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