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Individual

JOEL ELLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
2805 MID CITIES DR STE 1, BENTONVILLE, AR 72712-4291
(479) 271-7634
(479) 271-7654
Mailing address
PO BOX 497, AUGUSTA, AR 72006-0497
(870) 347-2534

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0000
AR
1041C0700X
Clinical Social Worker
Primary
10155-C
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0000
AR
Enumeration date
01/12/2022
Last updated
04/24/2026
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