Provider Demographics
NPI:1427703909
Name:MCELROY, BRIDGET ANNE
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:ANNE
Last Name:MCELROY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:832 N 24TH ST APT 2F
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-1900
Mailing Address - Country:US
Mailing Address - Phone:609-509-4134
Mailing Address - Fax:
Practice Address - Street 1:954 MONTGOMERY AVE STE 2
Practice Address - Street 2:
Practice Address - City:PENN VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19072-1938
Practice Address - Country:US
Practice Address - Phone:215-792-2924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-14
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW133457104100000X
PACW0245651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker