Provider Demographics
NPI:1972183218
Name:ABERA, ELSSA
Entity Type:Individual
Prefix:
First Name:ELSSA
Middle Name:
Last Name:ABERA
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 1:1509 RIDLEY AVE
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19013-5820
Mailing Address - Country:US
Mailing Address - Phone:619-847-3261
Mailing Address - Fax:
Practice Address - Street 1:100 CROZERVILLE RD
Practice Address - Street 2:
Practice Address - City:ASTON
Practice Address - State:PA
Practice Address - Zip Code:19014-1444
Practice Address - Country:US
Practice Address - Phone:610-938-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health