Provider Demographics
NPI:1851408553
Name:ELMAN, BARNETT D (PHD)
Entity Type:Individual
Prefix:
First Name:BARNETT
Middle Name:D
Last Name:ELMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5564 WILSON MILLS ROAD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HIGHLAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-3265
Mailing Address - Country:US
Mailing Address - Phone:440-461-1255
Mailing Address - Fax:440-461-1047
Practice Address - Street 1:5564 WILSON MILLS RD
Practice Address - Street 2:SUITE 201
Practice Address - City:HIGHLAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44143-3265
Practice Address - Country:US
Practice Address - Phone:440-461-1255
Practice Address - Fax:440-461-1047
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH862233101YA0400X
OHE-1012101YP2500X
OH5525103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHS 89443Medicare UPIN
OH23353Medicare ID - Type Unspecified
OH23354Medicare ID - Type Unspecified