Provider Demographics
NPI:1972240901
Name:ELONDRA COUNSELING SERVICES
Entity Type:Organization
Organization Name:ELONDRA COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELBA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CALDERON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:301-520-4109
Mailing Address - Street 1:17024 MOSS SIDE LN
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-2936
Mailing Address - Country:US
Mailing Address - Phone:301-520-4108
Mailing Address - Fax:
Practice Address - Street 1:6490 LANDOVER RD STE E
Practice Address - Street 2:
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785-1443
Practice Address - Country:US
Practice Address - Phone:301-276-2352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-20
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)