Healthcare Provider Details

I. General information

NPI: 1730091596
Provider Name (Legal Business Name): JOSEPH ELY LCSW PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2832 PAXTON AVE
PALMDALE CA
93551-1015
US

IV. Provider business mailing address

1860 QUAIL RUN WAY
SPRING HILL TN
37174-4203
US

V. Phone/Fax

Practice location:
  • Phone: 661-524-9940
  • Fax: 661-524-9950
Mailing address:
  • Phone: 661-524-9940
  • Fax: 661-524-9950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH ELY
Title or Position: OWNER
Credential: LCSW
Phone: 661-524-9940