| Teresa Ellsworth, Lcsw | |
|
2219 Harbor Lake Dr Fleming Island FL 32003-7796 | |
| (734) 673-3075 | |
| (904) 375-8347 |
| Full Name | Teresa Ellsworth, Lcsw |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2219 Harbor Lake Dr, Fleming Island, Florida |
| Authorized Official Name and Position | Teresa Ellsworth (OWNER) |
| Authorized Official Contact | 7346733075 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Teresa Ellsworth, Lcsw 2219 Harbor Lake Dr Fleming Island FL 32003-7796 Ph: (734) 673-3075 | Teresa Ellsworth, Lcsw 2219 Harbor Lake Dr Fleming Island FL 32003-7796 Ph: (734) 673-3075 |
| NPI Number | 1871067736 |
|---|---|
| Provider Enumeration Date | 01/14/2019 |
| Last Update Date | 01/14/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871067736 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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