Provider Demographics
NPI:1891910543
Name:FRANK, ELAINE (MSW)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:FRANK
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:637 W PHIL ELLENA ST
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-3524
Mailing Address - Country:US
Mailing Address - Phone:215-849-2630
Mailing Address - Fax:
Practice Address - Street 1:3900 CITY AVE
Practice Address - Street 2:D-108
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-2908
Practice Address - Country:US
Practice Address - Phone:215-879-4030
Practice Address - Fax:215-849-2322
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW003033L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAFR647835OtherHIGHMARK BS
PA0478752000OtherINDEPENDENCE BC