Provider Demographics
NPI:1518047364
Name:FERREIRA, ELLEN SUZANNE (MA, LPC, LMFT)
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:SUZANNE
Last Name:FERREIRA
Suffix:
Gender:F
Credentials:MA, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 MAGNOLIA LN
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-2501
Mailing Address - Country:US
Mailing Address - Phone:936-756-6894
Mailing Address - Fax:
Practice Address - Street 1:702 N THOMPSON ST
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77301-2576
Practice Address - Country:US
Practice Address - Phone:936-718-1131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12311101YM0800X
TX4642106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist