| Jackson Behavioral Health Professionals, Pllc | |
|
1013 Master St Corbin KY 40701-1065 | |
| (606) 526-9500 | |
| (606) 526-8080 |
| Full Name | Jackson Behavioral Health Professionals, Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1013 Master St, Corbin, Kentucky |
| Authorized Official Name and Position | William Matt Ellison (PROPRIETOR) |
| Authorized Official Contact | 6065269500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Behavioral Health Professionals, Pllc Po Box 2343 London KY 40743-2343 Ph: (606) 526-9500 | Jackson Behavioral Health Professionals, Pllc 1013 Master St Corbin KY 40701-1065 Ph: (606) 526-9500 |
| NPI Number | 1336213784 |
|---|---|
| Provider Enumeration Date | 11/19/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336213784 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | KY0480 (Kentucky) | Primary |
| 1041C0700X | Social Worker - Clinical | KY1625 (Kentucky) | Primary |
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