Organization
MALLORIE ELY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MALLORIE ELY LCSW (OWNER/CLINICIAN)
(208) 610-0996
Entity
Organization
Contact information
Practice address
1009 HIGHWAY 2 STE D, SANDPOINT, ID 83864-2713
(208) 610-0996
Mailing address
PO BOX 484, KOOTENAI, ID 83840-0484
(208) 610-0996
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
12/20/2019
Last updated
12/23/2025
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