Individual
MICHAEL ELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
115 ROCKWOOD LN, HAZARD, KY 41701-9415
(800) 575-7223
(600) 436-5797
Mailing address
PO BOX 1029, BETHEL, AK 99559-1029
(907) 543-6800
(907) 543-7101
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5122
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100397170
—
KY
Enumeration date
06/03/2013
Last updated
09/19/2023
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