Basic Information
| Provider Information | |||||||||
| NPI: | 1366740458 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ELEK | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | WARD | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | MSSA, LSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 32182 SPRINGSIDE LN | ||||||||
| Address2: | |||||||||
| City: | SOLON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441392055 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8043357220 | ||||||||
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| Practice Location | |||||||||
| Address1: | 22001 FAIRMOUNT BLVD | ||||||||
| Address2: | |||||||||
| City: | SHAKER HEIGHTS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441184819 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2163208704 | ||||||||
| FaxNumber: | 2163208748 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2011 | ||||||||
| LastUpdateDate: | 03/14/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | S 1000771 | OH | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.