Marylynn Ellsworth, LPC, CTSS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC-21654 Issued in AZ

Practice address

2633 E Indian School Rd Ste 250
Phoenix, AZ 85016-0703

Phone

(602) 492-1010

NPI assigned

Jun 15, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Az Therapy LLC

  dba Road to Therapy

  • Clinical Social Worker
  • Phoenix, AZ
  • NPI 1548772684
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1686787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1801571179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4017 E TETHER TRL",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850508970",
            "telephone_number": "480-231-3184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2633 E INDIAN SCHOOL RD STE 250",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850160703",
            "telephone_number": "602-492-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLSWORTH",
        "first_name": "MARYLYNN",
        "name_prefix": "Ms.",
        "credential": "LPC, CTSS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-15",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-21654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Ells
• Jordan Luke Ellstrom, PHARM.D.
• Verity Ellsworth Denham, RDH, BS
• Benjamin Ellsworth, MD
• German Ellsworth
• Matthew Ellsworth, PHARMD
• Nidia Zobeida Elm, LMFT
• Ahmed Zakria Youssef Elmaadawi, M.D.,
• Ahmed Elmadani
• Murtada Elmahdi

• Professional Counselor in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Professional Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.