Individual
MS. DEBORAH LYNN ELLSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
649 AMITY ROAD, BETHANY, CT 06524
(203) 530-2852
(203) 891-6128
Mailing address
649 AMITY ROAD, UNIT 103, BETHANY, CT 06524
(203) 530-2852
(203) 891-6128
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
003980
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008037431
—
CT
Enumeration date
03/12/2009
Last updated
05/15/2019
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