Provider Demographics
NPI:1750766457
Name:EELLS, ELIZABETH PEARL (T-LPC, MT-BC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:PEARL
Last Name:EELLS
Suffix:
Gender:F
Credentials:T-LPC, MT-BC
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:PEARL
Other - Last Name:BURDETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:134 S SANTA FE AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-2800
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:134 S SANTA FE AVE STE 130
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-2800
Practice Address - Country:US
Practice Address - Phone:785-823-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-22
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KST-LPC 2775101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health