Provider Demographics
NPI:1114238102
Name:ELG, KAYSIE LYNN (MED)
Entity Type:Individual
Prefix:MS
First Name:KAYSIE
Middle Name:LYNN
Last Name:ELG
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 HADLEY ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01118-2335
Mailing Address - Country:US
Mailing Address - Phone:413-233-6313
Mailing Address - Fax:
Practice Address - Street 1:77 MILL ST
Practice Address - Street 2:SUITE 251
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-4598
Practice Address - Country:US
Practice Address - Phone:413-568-6141
Practice Address - Fax:413-572-4106
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-24
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health