Provider Demographics
NPI:1144314634
Name:MCELHINNEY, DALE WARREN (PSYD)
Entity type:Individual
Prefix:
First Name:DALE
Middle Name:WARREN
Last Name:MCELHINNEY
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 EASTON RDL.
Mailing Address - Street 2:D-3
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090
Mailing Address - Country:US
Mailing Address - Phone:215-659-2250
Mailing Address - Fax:
Practice Address - Street 1:607 EASTON RDL.
Practice Address - Street 2:D-3
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090
Practice Address - Country:US
Practice Address - Phone:215-659-2250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005046-L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA414568Medicare ID - Type Unspecified
PAR06847Medicare UPIN