Josephine Anne Ellsworth, MA, LPC
Individual provider Active NPI Counselor · Benson, AZ
NPI 1467735217 · NPPES record last updated Sep 27, 2011
Key facts
- NPI
- 1467735217
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 264199 (AZ)
- Practice address
- 811 Maverick Lane
Benson, AZ 85602 - Phone
- (520) 548-2929
- NPI assigned
- Sep 27, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 264199 | AZ | MD | Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 264199 | AZ | Yes |
Addresses
Primary practice location
811 Maverick Lane
Benson, AZ 85602
Mailing address
811 Maverick Lane
Benson, AZ 85602
Phone (520) 548-2929
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 264199 | Other | AZ | NBCC |
| 2541 | Other | AZ | LPC |
Other providers in Benson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 27, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.