Individual
ELISE MARKHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.,CADC, BCIAC
Contact information
Practice address
9509 US HIGHWAY 42, FALSOFT BUILING, SUITE 201A, PROSPECT, KY 40059-9290
(502) 644-6975
Mailing address
9909 FOUR SEASONS LN, LOUISVILLE, KY 40241-2117
(502) 644-6975
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0711
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11574925
CAQH
—
05
—
30605018
—
KY
Enumeration date
05/22/2006
Last updated
04/13/2012
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