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Individual

RITA MARIE ELLINGTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D., CDCS, ADMN

Contact information

Practice address
3100 S CUSHMAN ST, FAIRBANKS, AK 99701-7516
(907) 452-6251
(907) 456-4849
Mailing address
4382 BISHOP CIR, FAIRBANKS, AK 99709-3435
(907) 456-1523

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCS 2376
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1116
ST ALASKA ADMIN CERT
AK
01
2376
ALASKA CDCS CERTIFICATION
AK
Enumeration date
04/20/2007
Last updated
07/08/2007
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