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Organization

ELWYN OF PENNSYLVANIA AND DELAWARE

Active
Other names
Elwyn Mental Health Services
Organization subpart
No

Provider details

NPI number
Authorized official
DONNA BUSCH (DIR. OF CONTRACT AND CREDENTIALING)
(445) 206-3028
Entity
Organization

Contact information

Practice address
12 N PRESTON ST, PHILADELPHIA, PA 19104-2211
(215) 895-5588
Mailing address
111 ELWYN RD, ELWYN, PA 19063-4622
(610) 891-7007
(610) 891-2666

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
103K00000X
Behavior Analyst
103T00000X
Psychologist
2084P0800X
Psychiatry Physician
2084P0804X
Child & Adolescent Psychiatry Physician
251S00000X
Community/Behavioral Health Agency
Primary
261Q00000X
Clinic/Center
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
261QM0850X
Adult Mental Health Clinic/Center
261QM0855X
Adolescent and Children Mental Health Clinic/Center
261QR0400X
Rehabilitation Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1000021240620
PA
05
1000021240673
PA
05
1000021240674
PA
05
1000021240687
PA
05
1000021240691
PA
05
1000021240700
PA
05
1000021240714
PA
05
1000021240715
PA
05
1000021240716
PA
Enumeration date
02/07/2007
Last updated
09/17/2025
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