Provider Demographics
NPI:1467271510
Name:FLEM, ELENA (MS BCBA LBS)
Entity type:Individual
Prefix:
First Name:ELENA
Middle Name:
Last Name:FLEM
Suffix:
Gender:F
Credentials:MS BCBA LBS
Other - Prefix:
Other - First Name:ELENA
Other - Middle Name:
Other - Last Name:KONOVALOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1404 2ND ST
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-4649
Mailing Address - Country:US
Mailing Address - Phone:215-971-6609
Mailing Address - Fax:
Practice Address - Street 1:1404 2ND ST
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-4649
Practice Address - Country:US
Practice Address - Phone:215-971-6609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-07
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH005574103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty