Provider Demographics
NPI:1457826992
Name:MCELWAIN, ALEXIS (CSW)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:MCELWAIN
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:
Other - Last Name:KENNY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8792 SPARTAN CT
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-7767
Mailing Address - Country:US
Mailing Address - Phone:270-608-4980
Mailing Address - Fax:
Practice Address - Street 1:8792 SPARTAN CT
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-7767
Practice Address - Country:US
Practice Address - Phone:270-608-4980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-11
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2530651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical