Provider Demographics
NPI:1992856561
Name:ELMENDORF, DANA JOY (ATR-BC, LPC)
Entity Type:Individual
Prefix:MS
First Name:DANA
Middle Name:JOY
Last Name:ELMENDORF
Suffix:
Gender:F
Credentials:ATR-BC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1424 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-3833
Mailing Address - Country:US
Mailing Address - Phone:412-824-7717
Mailing Address - Fax:
Practice Address - Street 1:FORBES REGIONAL HOSPITAL
Practice Address - Street 2:2570 HAYMAKER RD
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146
Practice Address - Country:US
Practice Address - Phone:412-858-3057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC002916101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health