Sally Ellsworth is a Peer Specialist based in Bend, OR. Sally Ellsworth practices in Bend, OR. The NPI Number for Sally Ellsworth is 1184220204 and holds a License No. 000004375 (Oregon).
The current practice location address for Sally Ellsworth is 20813 Liberty Ln, Bend, OR and can be reached out via phone at 541-279-8630.
Location: 20813 Liberty Ln, Bend, OR, 97701-8596
Provider Profile Details
NPI Number
1184220204
Provider Name
Sally Ellsworth
Credential
Provider Entity Type
Individual
Gender
Female
Address
20813 Liberty Ln, Bend, OR, 97701-8596
Phone Number
541-279-8630
Fax Number
Provider Enumeration Date
12/05/2020
Last Update Date
03/10/2024
Provider Business Practice Location Address Details
Address
20813 Liberty Ln
City
State
Zip
97701-8596
Phone Number
541-279-8630
Fax Number
Provider Business Mailing Address Details
Address
20813 Liberty Ln
City
State
Zip
97701-8596
Phone Number
541-279-8630
Fax Number
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
License No.
000004375 (Oregon)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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