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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