| Elders Counseling Group | |
|
101 Greenwood Ave Suite 270 Jenkintown PA 19046-2627 | |
| (215) 886-5331 | |
| (215) 886-5332 |
| Full Name | Elders Counseling Group |
|---|---|
| Speciality | Counselor |
| Location | 101 Greenwood Ave, Jenkintown, Pennsylvania |
| Authorized Official Name and Position | Zakia West (PRESIDENT) |
| Authorized Official Contact | 2158865331 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elders Counseling Group 101 Greenwood Ave Suite 270 Jenkintown PA 19046-2627 Ph: (215) 886-5331 | Elders Counseling Group 101 Greenwood Ave Suite 270 Jenkintown PA 19046-2627 Ph: (215) 886-5331 |
| NPI Number | 1073545679 |
|---|---|
| Provider Enumeration Date | 07/06/2006 |
| Last Update Date | 07/25/2016 |
| Medicare PECOS PAC ID | 6204120983 |
|---|---|
| Medicare Enrollment ID | O20160803000470 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073545679 | NPI | - | NPPES |
| 261205000 | Other | PA | GROUP MIS NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | PS015007 (Pennsylvania) | Primary |
| Provider Name | Gary B Kozick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912945296 PECOS PAC ID: 4880651926 Enrollment ID: I20090211000079 |
| Provider Name | Riki Fire |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114063427 PECOS PAC ID: 5991963399 Enrollment ID: I20120214000584 |
| Provider Name | Jesse D Matthews |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194140848 PECOS PAC ID: 0941420236 Enrollment ID: I20141009000195 |
| Provider Name | Jared Moore |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679971865 PECOS PAC ID: 2860708070 Enrollment ID: I20150902003180 |
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