Individual
AMANDA ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LCPC
Contact information
Practice address
52 CHRISTIAN RIDGE RD, ELLSWORTH, ME 04605-3210
(207) 667-5357
Mailing address
52 CHRISTIAN RIDGE RD, ELLSWORTH, ME 04605-3210
(207) 610-9244
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
XL5368
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CC6953
STATE OF MAINE
ME
Enumeration date
10/09/2019
Last updated
03/01/2023
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