Manon Ellsworth, MS, MFT, LPC
Individual provider Active NPI Professional Counselor · Hamilton, MO
NPI 1487014205 · NPPES record last updated Jan 25, 2023
Key facts
- NPI
- 1487014205
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- Practice address
- 507 W McGaughy St
Hamilton, MO 64644-1048 - Phone
- (303) 214-8054
- NPI assigned
- Mar 7, 2016
- 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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14663 | CO | MD | Counseling Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Mental Health Counselor | 101YM0800X | |||
| Psychologist | 103T00000X | |||
| Cognitive & Behavioral Psychologist | 103TB0200X | 14663 | CO | |
| Clinical Psychologist | 103TC0700X | 14663 | CO | |
| Counseling Psychologist | 103TC1900X | |||
| Counseling Psychologist | 103TC1900X | 14663 | CO | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 14663 | CO | |
| Family Psychologist | 103TF0000X | 14663 | CO | |
| Group Psychotherapy Psychologist | 103TP2701X | |||
| Marriage & Family Therapist | 106H00000X | |||
| Professional Counselor | 101YP2500X | Yes |
Addresses
Primary practice location
507 W McGaughy St
Hamilton, MO 64644-1048
Mailing address
PO Box 294
Hamilton, MO 64644-0294
Phone (303) 214-8054
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487014205 | Medicaid | MO |
Other providers in Hamilton, MO
- Bowens Point Chiropractic, LLC
- Shawn Wayne Brown
- Cameron Regional Medical Center Inc
- Sarah Margaret Connelly
- Kala Ann Cummings
- Hamilton No 1 Inc
- Hamilton R-II School District
- Natalie Jill Hibler
- Innate Way Family Chiropractic, LLC
- William V Irby
All providers in Hamilton, MO · Professional Counselor in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2023. 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.