Individual
BETHANY LYNN ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
44 E GORDON ST, BEL AIR, MD 21014-2916
(410) 366-1980
Mailing address
102 HERITAGE WAY NE, LEESBURG, VA 20176-4544
(703) 771-5100
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
0701015002
VA
101YM0800X
Mental Health Counselor
Primary
LC17226
MD
Other
Enumeration date
06/01/2021
Last updated
12/11/2025
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