Provider Demographics
NPI:1770506172
Name:NAHAI, ELAINE KAY
Entity Type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:KAY
Last Name:NAHAI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15809 BELLIS DRIVE
Mailing Address - Street 2:
Mailing Address - City:WOODBINE
Mailing Address - State:MD
Mailing Address - Zip Code:21797-8421
Mailing Address - Country:US
Mailing Address - Phone:410-489-5090
Mailing Address - Fax:
Practice Address - Street 1:6106 EDMONDSON AVENUE
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-1825
Practice Address - Country:US
Practice Address - Phone:410-489-5090
Practice Address - Fax:410-489-0830
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD052741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
QW39EKMedicare ID - Type Unspecified