Ellsworth, Teresa
Ellsworth, Teresa is an sole proprietor health care provider with primary practice located at 2219 Harbor Lake Dr , Fleming Island FL 32003-7796. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Ellsworth, Teresa can be contacted via phone (734) 673-3075.Contact Information
Primary practice address
2219 Harbor Lake Dr
Fleming Island FL 32003-7796
Phone: (734) 673-3075
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 6801066406 | Michigan |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | SW11351 | Florida |
Profile Details
| NPI number | 1366650954 |
|---|---|
| LBN Legal business name | Ellsworth, Teresa |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 18th, 2007 |
| Last updated | Sep 30th, 2016 - about 8 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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