Provider Demographics
NPI:1821711862
Name:MOTSKO, ELLEN ELIZABETH (LPC-A)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:ELIZABETH
Last Name:MOTSKO
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 SCHRAFFTS DR
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06705-3222
Mailing Address - Country:US
Mailing Address - Phone:203-518-8218
Mailing Address - Fax:
Practice Address - Street 1:211 SCHRAFFTS DR
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06705-3222
Practice Address - Country:US
Practice Address - Phone:203-518-8218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5595101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health