Provider Demographics
NPI:1912150988
Name:ELDER CONSULTANT SERVICES, INC.
Entity Type:Organization
Organization Name:ELDER CONSULTANT SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:LOHNES
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:774-535-1007
Mailing Address - Street 1:4 SAINT MARKS RD
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-1568
Mailing Address - Country:US
Mailing Address - Phone:774-535-1007
Mailing Address - Fax:508-853-1811
Practice Address - Street 1:4 SAINT MARKS RD
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01606-1568
Practice Address - Country:US
Practice Address - Phone:774-535-1007
Practice Address - Fax:508-853-1811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMENTAL HEALTH #1297251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1396774428OtherNPI