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Organization
JACKSON BEHAVIORAL HEALTH PROFESSIONALS, PLLC
Active
Organization
JACKSON BEHAVIORAL HEALTH PROFESSIONALS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM MATT ELLISON LCSW (PROPRIETOR)
(606) 526-9500
Entity
Organization
Contact information
Practice address
1013 MASTER ST, CORBIN, KY 40701-1065
(606) 526-9500
(606) 526-8080
Mailing address
PO BOX 2343, LONDON, KY 40743-2343
(606) 526-9500
(606) 526-8080
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
KY0480
KY
1041C0700X
Clinical Social Worker
KY1625
KY
Other
Enumeration date
11/19/2006
Last updated
09/11/2025
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