Individual
SAMANTHA ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11-13 SUNFLOWER AVE STE 1020, PARAMUS, NJ 07652-3756
(973) 529-8913
Mailing address
PO BOX 748465, ATLANTA, GA 30374-8465
(855) 284-7483
(617) 807-0958
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
37AC00591000
NJ
101YP2500X
Professional Counselor
Primary
37PC01028000
NJ
Other
Enumeration date
08/16/2021
Last updated
02/07/2026
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