Provider Demographics
NPI:1043937972
Name:ELVA DEGEORGE, LCSW
Entity Type:Organization
Organization Name:ELVA DEGEORGE, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ELVA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEGEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-300-3164
Mailing Address - Street 1:1229 BOONE AVE
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:PA
Mailing Address - Zip Code:19001-3503
Mailing Address - Country:US
Mailing Address - Phone:215-300-3164
Mailing Address - Fax:
Practice Address - Street 1:415 DAVISVILLE RD STE 5
Practice Address - Street 2:
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-2700
Practice Address - Country:US
Practice Address - Phone:267-300-3164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-21
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty