Provider Demographics
NPI:1568810869
Name:SZCZESNY, ELANA (PHD)
Entity Type:Individual
Prefix:
First Name:ELANA
Middle Name:
Last Name:SZCZESNY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4812 BALTIMORE AVE
Mailing Address - Street 2:APT 3R
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19143-3419
Mailing Address - Country:US
Mailing Address - Phone:301-641-9548
Mailing Address - Fax:215-823-4123
Practice Address - Street 1:4812 BALTIMORE AVE
Practice Address - Street 2:APT 3R
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19143-3419
Practice Address - Country:US
Practice Address - Phone:301-641-9548
Practice Address - Fax:215-823-4123
Is Sole Proprietor?:No
Enumeration Date:2016-05-26
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS018043103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical