Healthcare Provider Details

I. General information

NPI: 1952449225
Provider Name (Legal Business Name): ELAINE A. MALEC PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 07/08/2023
Certification Date: 07/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 CROWE AVE
MARS PA
16046-3303
US

IV. Provider business mailing address

195 CROWE AVE
MARS PA
16046-3303
US

V. Phone/Fax

Practice location:
  • Phone: 724-772-4949
  • Fax: 724-625-4950
Mailing address:
  • Phone: 724-772-4949
  • Fax: 724-625-4950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPS007944L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier000853464
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerHIGHMARK BCBS ID
# 2
Identifier07266776
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: