Individual
LISA ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, LCADC
Contact information
Practice address
107 PATERSON AVE, HASBROUCK HEIGHTS, NJ 07604-1414
(551) 900-1496
Mailing address
107 PATERSON AVE, HASBROUCK HEIGHTS, NJ 07604-1414
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00236900
NJ
101YM0800X
Mental Health Counselor
37AC00328500
NJ
101YP2500X
Professional Counselor
37PC00786200
NJ
Other
Enumeration date
05/27/2019
Last updated
10/18/2021
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