Provider Demographics
NPI:1144408311
Name:SOHUS, ELLEN (MC, LPC, LISAC)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:SOHUS
Suffix:
Gender:F
Credentials:MC, LPC, LISAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 N 32ND ST
Mailing Address - Street 2:SUITE, 100
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-3396
Mailing Address - Country:US
Mailing Address - Phone:602-954-9250
Mailing Address - Fax:602-954-9260
Practice Address - Street 1:4500 N 32ND ST
Practice Address - Street 2:SUITE, 100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-3396
Practice Address - Country:US
Practice Address - Phone:602-954-9250
Practice Address - Fax:602-954-9260
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-09
Last Update Date:2008-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC-10362101YA0400X
AZLPC-10584101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)