Provider Demographics
NPI:1881295806
Name:ELLETT, ERIN HOPE (LPC)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:HOPE
Last Name:ELLETT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 N WEST ST
Mailing Address - Street 2:
Mailing Address - City:BERTRAM
Mailing Address - State:TX
Mailing Address - Zip Code:78605-4321
Mailing Address - Country:US
Mailing Address - Phone:512-627-7962
Mailing Address - Fax:
Practice Address - Street 1:360 N WEST ST
Practice Address - Street 2:
Practice Address - City:BERTRAM
Practice Address - State:TX
Practice Address - Zip Code:78605-4321
Practice Address - Country:US
Practice Address - Phone:512-627-7962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor