MR. Antonio Clarence Ellzey SR., NCC, LCPC

NPI #1174909451 in Mokena, Illinois

Provider Information

NPI Number: 1174909451
Entity Type: Individual
Name: MR. Antonio Clarence Ellzey SR., NCC, LCPC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Professional
Credential: NCC, LCPC
Enumeration Date: Aug 10, 2015
Last Updated: Oct 28, 2015

Practice Location

Address: 9435 BORMET DR STE 5
City: Mokena
State: Illinois
ZIP Code: 60448-7401
Phone: (708) 995-7226

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X	Primary

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