Provider Demographics
NPI:1770751554
Name:LINSLEY, ELLEN KAY (LCSW)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:KAY
Last Name:LINSLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:PROF
Other - First Name:ELLEN
Other - Middle Name:KAY
Other - Last Name:LINSLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:1363 W SPRUCE AVE
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-5327
Mailing Address - Country:US
Mailing Address - Phone:907-376-2411
Mailing Address - Fax:907-352-3363
Practice Address - Street 1:1363 W SPRUCE AVE
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-5327
Practice Address - Country:US
Practice Address - Phone:907-376-2411
Practice Address - Fax:907-352-3363
Is Sole Proprietor?:No
Enumeration Date:2008-02-14
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK168101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health