| Doctor Name: | TRACY JEWELL ELAM |
| NPI Number: | 1699957704 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CSW |
| License Number: | 6237 |
| Business Practice Address: | 70 Main St Frenchburg, KY - 403228318 |
| Business Phone Number: | 6067682131 |
| Business Fax Number: | 6067682134 |
| Mailing Address: | Po Box 790, ASHLAND |
| State: | KY |
| Postal Code: | 411050790 |
| Phone Number: | 6063298588 |
| Fax Number: | 6063298195 |
| NPI Enumeration Date: | 11/30/2007 |
| NPI Last Update Date: | 11/06/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 6237 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |