Provider Demographics
NPI:1053816777
Name:MCELDOWNEY, BOBBIE JO (CDCA, QMHS)
Entity Type:Individual
Prefix:
First Name:BOBBIE
Middle Name:JO
Last Name:MCELDOWNEY
Suffix:
Gender:F
Credentials:CDCA, QMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 NORTH SANDUSKY
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-5128
Mailing Address - Country:US
Mailing Address - Phone:740-203-3800
Mailing Address - Fax:
Practice Address - Street 1:245 NEAL AVE
Practice Address - Street 2:
Practice Address - City:MOUNT GILEAD
Practice Address - State:OH
Practice Address - Zip Code:43338-9372
Practice Address - Country:US
Practice Address - Phone:419-946-6734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH171285101YA0400X
171M00000X
OH174645101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1053816777Medicaid