Organization
AMY C. ELLIS
Active
Other names
Amy C. Ellis
Organization subpart
No
Provider details
NPI number
Authorized official
AMY ELLIS (LMHC)
(850) 243-7035
Entity
Organization
Contact information
Practice address
124 E MIRACLE STRIP PKWY STE 602, MARY ESTHER, FL 32569-1991
(850) 243-8529
(850) 243-8529
Mailing address
5170 ANNIE RUTH ST, MILTON, FL 32570-8153
(850) 261-9032
(850) 243-8529
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH6475
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MH6475
STATE LICENSE
FL
Enumeration date
07/26/2017
Last updated
06/16/2018
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