=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730091596
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JOSEPH ELY LCSW PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/17/2026
-----------------------------------------------------
Last Update Date | 09/17/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2832 PAXTON AVE
-----------------------------------------------------
City | PALMDALE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93551-1015
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-524-9940
-----------------------------------------------------
Fax | 661-524-9950
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1860 QUAIL RUN WAY
-----------------------------------------------------
City | SPRING HILL
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37174-4203
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-524-9940
-----------------------------------------------------
Fax | 661-524-9950
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JOSEPH ELY
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 661-524-9940
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------