Provider Demographics
NPI:1437612819
Name:ELLINGSON, KELSEY MAUREEN (MS, NCC, LHMC)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:MAUREEN
Last Name:ELLINGSON
Suffix:
Gender:F
Credentials:MS, NCC, LHMC
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:MAUREEN ELLINGSON
Other - Last Name:WATSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, NCC, LMHC
Mailing Address - Street 1:557 RAINBOW DR
Mailing Address - Street 2:
Mailing Address - City:SEDRO WOOLLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98284-9569
Mailing Address - Country:US
Mailing Address - Phone:507-696-0502
Mailing Address - Fax:
Practice Address - Street 1:15315 1ST AVE NE STE 216
Practice Address - Street 2:
Practice Address - City:DUVALL
Practice Address - State:WA
Practice Address - Zip Code:98019-5005
Practice Address - Country:US
Practice Address - Phone:425-780-6227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-11
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health