Provider Demographics
NPI:1073545679
Name:ELDERS COUNSELING GROUP
Entity Type:Organization
Organization Name:ELDERS COUNSELING GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ZAKIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:215-886-5331
Mailing Address - Street 1:101 GREENWOOD AVE
Mailing Address - Street 2:SUITE 270
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-2627
Mailing Address - Country:US
Mailing Address - Phone:215-886-5331
Mailing Address - Fax:215-886-5332
Practice Address - Street 1:101 GREENWOOD AVE
Practice Address - Street 2:SUITE 270
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-2627
Practice Address - Country:US
Practice Address - Phone:215-886-5331
Practice Address - Fax:215-886-5332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015007101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA261205000OtherGROUP MIS NUMBER
PA769199Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER