Provider Demographics
NPI:1811221971
Name:ELVA E. BLANKS, PH.D. LLC
Entity Type:Organization
Organization Name:ELVA E. BLANKS, PH.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ELVA
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:BLANKS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:602-751-6335
Mailing Address - Street 1:3295 N. DRINKWATER BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251
Mailing Address - Country:US
Mailing Address - Phone:602-751-6335
Mailing Address - Fax:
Practice Address - Street 1:3295 N DRINKWATER BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6492
Practice Address - Country:US
Practice Address - Phone:602-751-6335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-22
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4005103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty