Provider Demographics
NPI:1922154814
Name:ELLETT, LAURIE MORROW (LCSW, CADCII)
Entity Type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:MORROW
Last Name:ELLETT
Suffix:
Gender:F
Credentials:LCSW, CADCII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 NW 132ND ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98685-2903
Mailing Address - Country:US
Mailing Address - Phone:503-706-9234
Mailing Address - Fax:503-648-0755
Practice Address - Street 1:230 NE 2ND AVE STE C
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-3074
Practice Address - Country:US
Practice Address - Phone:503-648-0753
Practice Address - Fax:503-648-0755
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR96-04-86101YA0400X
OR26091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical