Individual
ELLEN LANDRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
267 FLYE POINT RD, BROOKLIN, ME 04616-3225
(305) 849-0646
(617) 254-3461
Mailing address
267 FLYE POINT RD, BROOKLIN, ME 04616-3225
(305) 849-0646
(617) 254-3461
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
21960
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21960
MASSACHUSETTS DIVISION OF PROFESSIONAL LICENSURE
MA
01
—
2584582
DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION
MA
01
—
LC18429
STATE OF MAINE DEPT OF PROFESSIONAL AND FINANCIAL REGULATION
ME
Enumeration date
10/23/2014
Last updated
02/10/2021
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