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ELISE MARKHAM M.A.,CADC, BCIAC

Addiction Substance Use Disorder

Prospect, Kentucky

Provider NPI: 1376598219

Provider Information:
 ELISE  MARKHAM M.A.,CADC, BCIAC
Gender: F
Sole Proprietor


Practice Location:
9509 US HIGHWAY 42 FALSOFT BUILING, SUITE 201A PROSPECT, KY 40059 US
Tel: 502-644-6975  Fax: --

Business Mailing Address:
9909 FOUR SEASONS LN  LOUISVILLE, KY 40241 US
Tel: 502-644-6975  Fax: --

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
KY0711

Other Provider Identifiers:

IssuerNumberStateType
30605018KY05
CAQH1157492501
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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