Healthcare Provider Details

I. General information

NPI: 1720487432
Provider Name (Legal Business Name): ELAINE MARIE MCHALE MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2014
Last Update Date: 04/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 12TH ST STE 212
KEY WEST FL
33040-3001
US

IV. Provider business mailing address

137 PEARY CT UNIT C
KEY WEST FL
33040-7735
US

V. Phone/Fax

Practice location:
  • Phone: 305-783-3677
  • Fax: 305-407-3955
Mailing address:
  • Phone: 856-816-2794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW15014
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: