Provider Demographics
NPI:1174664767
Name:ELDER, DAWN LEAH (MA, NCC, LPC)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:LEAH
Last Name:ELDER
Suffix:
Gender:F
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:D/B/A EMBRACE HOPE
Other - Middle Name:COUNSELING
Other - Last Name:SERVICES, LLC
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5070 TRAIL SIDE CT
Mailing Address - Street 2:
Mailing Address - City:JEANNETTE
Mailing Address - State:PA
Mailing Address - Zip Code:15644-4770
Mailing Address - Country:US
Mailing Address - Phone:412-580-1049
Mailing Address - Fax:724-392-7903
Practice Address - Street 1:4068 OLD WILLIAM PENN HWY
Practice Address - Street 2:
Practice Address - City:MURRYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15668-1823
Practice Address - Country:US
Practice Address - Phone:412-580-1049
Practice Address - Fax:724-392-7903
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003701101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA81-1431030OtherTAX ID