Provider Demographics
NPI:1215164975
Name:MCELWEE, JOHN D (BCBA)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:D
Last Name:MCELWEE
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:112 HAVERFORD DR
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702-7207
Mailing Address - Country:US
Mailing Address - Phone:570-479-2066
Mailing Address - Fax:570-655-5934
Practice Address - Street 1:112 HAVERFORD DR
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-7207
Practice Address - Country:US
Practice Address - Phone:570-479-2066
Practice Address - Fax:570-655-5934
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-19
Last Update Date:2009-06-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PA1-99-0155103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst