Healthcare Provider Details

I. General information

NPI: 1699803551
Provider Name (Legal Business Name): ELLEN ELIZABETH FLYNN LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WASHINGTON ST
TAUNTON MA
02780-3960
US

IV. Provider business mailing address

30 CHURCH ST APT 4
NORTH ATTLEBORO MA
02760-7604
US

V. Phone/Fax

Practice location:
  • Phone: 508-828-9116
  • Fax:
Mailing address:
  • Phone: 508-316-0633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number113535
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: