Provider Demographics
NPI:1720179468
Name:VELKA, ELAINE (LISW)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:VELKA
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12300 MCCRACKEN RD
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-2914
Mailing Address - Country:US
Mailing Address - Phone:216-587-8350
Mailing Address - Fax:216-587-8646
Practice Address - Street 1:12300 MCCRACKEN RD
Practice Address - Street 2:
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44125-2914
Practice Address - Country:US
Practice Address - Phone:216-587-8350
Practice Address - Fax:216-587-8646
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-00073091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000243296OtherUNICARE
OH353487OtherWELLCARE HEALTH PLAN
OH7377552OtherAETNA
OH000000243296OtherANTHEM PIN NUMBER
OH741001OtherBUCKEYE HEALTH PLAN
OHT07309OtherSUMMACARE HEALTH PLAN
OHSW76891Medicare PIN
OHSW16422Medicare PIN