Michael Ely, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

5122 Issued in KY

Practice address

115 Rockwood LN
Hazard, KY 41701-9415

Phone

(800) 575-7223

Fax

(600) 436-5797

NPI assigned

Jun 3, 2013

Last updated

Sep 19, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kentucky River Community Care, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hazard, KY
  • NPI 1528017142

  Clinical

  Medicare reassignment NPD
• Saint Joseph Medical Foundation, Inc.

  dba Premier Family Health Center

  • Family Medicine Physician
  • London, KY
  • NPI 1700226271
  NPD (past)
• Yukon-Kuskokwim Health Corporation

  • Psychiatric Residential Treatment Facility
  • Bethel, AK
  • NPI 1467679936
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1370217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1669819421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1029",
            "city": "BETHEL",
            "state": "AK",
            "postal_code": "995591029",
            "telephone_number": "907-543-6800",
            "fax_number": "907-543-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 ROCKWOOD LN",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417019415",
            "telephone_number": "800-575-7223",
            "fax_number": "600-436-5797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELY",
        "first_name": "MICHAEL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-03",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "5122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100397170",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Eldridge
• Freida Eldridge, LCSW
• Dawn Elkins, LPCC
• Raymond Elsoueidi, M.D.
• Ashley Brooke Elswick, APRN
• Empowerment Solutions, Inc.
• Debra Engle
• Mary A Engle, P.A.-C
• Tanya Engle
• Sheila Anne Epperson, CCC/SLP

• Clinical Social Worker in Hazard, KY
• Providers in Hazard, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.