person
Marina J. Ellis, LCPC
Professional Counselor in Pocatello, Idaho
NPI 1528107158

Marina J. Ellis is a Professional Counselor based in Chubbuck, ID and is specialized in Professional. Marina J. Ellis practices in Pocatello, ID and has the professional credentials of LCPC. The NPI Number for Marina J. Ellis is 1528107158 and holds a License No. LCPC303 (Idaho).

The current practice location address for Marina J. Ellis is 427 N Arthur Ave Ste B, Pocatello, ID and can be reached out via phone at 208-637-0334 and via fax at 208-237-9670.

Location: 427 N Arthur Ave Ste B, Pocatello, ID, 83202-0003
person
Provider Profile Details
NPI Number
1528107158
Provider Name
Marina J. Ellis
Credential
LCPC
Provider Entity Type
Individual
Gender
Female
Address
427 N Arthur Ave Ste B, Pocatello, ID, 83202-0003
Phone Number
208-637-0334
Fax Number
208-237-9670
Provider Enumeration Date
02/06/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
Q3717 01 ID BLUE CROSS
institution
Provider Business Practice Location Address Details
Address
427 N Arthur Ave Ste B
City
State
Zip
83204-3006
Phone Number
208-637-0334
Fax Number
208-237-9670
person
Provider Business Mailing Address Details
Address
427 N Arthur Ave Ste B
City
State
Zip
83204-3006
Phone Number
208-637-0334
Fax Number
208-237-9670
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
LCPC303 (Idaho)
Definition
Definition to come...
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