Ellis, Jennifer

Ellis, Jennifer is an individual health care provider with primary practice located at 3 Oak Dr Ste B , Maryville IL 62062-5635. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Ellis, Jennifer can be contacted via phone (618) 972-1568.

Contact Information

Primary practice address
3 Oak Dr Ste B Maryville IL 62062-5635
Phone: (618) 972-1568
Fax: (618) 205-3561
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X
Behavioral Health & Social Service Providers / Clinical 1041C0700X 149.026388 Illinois

Profile Details

NPI number 1043631237
LBN Legal business name Ellis, Jennifer
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 15th, 2013
Last updated Nov 21st, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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