Ellinwood, Jill Diane

Ellinwood, Jill Diane is an individual health care provider with primary practice located at 505 Broadway St , Baraboo WI 53913-2183. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Ellinwood, Jill Diane can be contacted via phone (608) 355-4214.

Contact Information

Primary practice address
505 Broadway St Baraboo WI 53913-2183
Phone: (608) 355-4214
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 647-125 Wisconsin
Behavioral Health & Social Service Providers / Clinical 1041C0700X 1197-123 Wisconsin

Profile Details

NPI number 1275666935
LBN Legal business name Ellinwood, Jill Diane
Credentials MA, LCSW, LPC
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 13th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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