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Individual

ELLEN LEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
320 E MAIN ST, STE 208, ASHLAND, OR 97520-6801
(541) 500-8655
Mailing address
PO BOX 4752, MEDFORD, OR 97501-0197
(415) 500-8655
(800) 433-1396

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L5017SR
OR
1041C0700X
Clinical Social Worker
LCS11989
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
FHC03906F
CA
Enumeration date
03/01/2007
Last updated
06/02/2020
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