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General NPI Number Information
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NPI Number | 1962282319
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Entity Type | Individual
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Provider Name | MICHELLE DAWN ELLERMAN LMHCA, ATR-P
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Gender | Female
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Dates
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Enumeration Date | 10/03/2023
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 105 BROADWAY ST
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City | VINCENNES
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State | IN
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Zip | 47591-1251
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Country | US
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Telephone | 812-790-2599
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Fax |
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Provider Business Mailing Address
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Address Line | 105 BROADWAY ST
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City | VINCENNES
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State | IN
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Zip | 47591-1251
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Country | US
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Telephone | 812-790-2599
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 88002155A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | 1583231
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 221700000X
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Taxonomy Name | Art Therapist
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License Number | 23-204
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License Number State | IN
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