Provider Demographics
NPI:1316544489
Name:ROUGIER, ELLESSE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:ELLESSE
Middle Name:
Last Name:ROUGIER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 N BELLWOODE DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-3409
Mailing Address - Country:US
Mailing Address - Phone:302-528-6791
Mailing Address - Fax:
Practice Address - Street 1:5201 W WOODMILL DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-4068
Practice Address - Country:US
Practice Address - Phone:302-384-7843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-02
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ-0000008104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker