Individual
ELLEN DENISE FIELLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1430 OLIVE ST, SUITE 400, SAINT LOUIS, MO 63103-2303
(314) 206-3405
(314) 206-3992
Mailing address
1430 OLIVE ST, SUITE 400, SAINT LOUIS, MO 63103-2303
(314) 206-3405
(314) 206-3992
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
069917-1
NY
1041C0700X
Clinical Social Worker
Primary
2012025911
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07300069917
—
NY
Enumeration date
08/13/2006
Last updated
01/16/2013
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