NPIMap

Organization Active NPI

Elwyn of Pennsylvania and Delaware

  • Community/Behavioral Health Agency
  • Philadelphia, PA
National Provider Identifier
1225546245
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
143430 Issued in PA
Legal business name
ELWYN OF PENNSYLVANIA AND DELAWARE
Practice address
3300 Henry Ave Ste 401
Philadelphia, PA 19129-1121
Phone
(267) 673-3383
NPI assigned
Jan 11, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Donna K Busch
Title
Dir. of Contracting Credentialing
Phone
(445) 206-3028

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 143430 PA Primary

Addresses

Primary practice location

3300 Henry Ave Ste 401
Philadelphia, PA 19129-1121

Mailing address

111 Elwyn Rd
Elwyn, PA 19063-4622
Phone (610) 891-7079

Other practice location 1

900 W Jefferson St
Philadelphia, PA 19122-3515
Phone (215) 895-5588

Other identifiers 1

IdentifierTypeStateIssuer
1000021240674MedicaidPA

Other names 1

  • Elwyn Crisis Services Philadelphia Other name

National Provider Directory

National Provider Directory
Tax ID family
Elwyn Medical Services61 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 20

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 20

Locations

900 W Jefferson St
Philadelphia, PA 19122
Phone (215) 895-5588

3300 Henry Ave
Ste 401
Philadelphia, PA 19129
Phone (267) 673-3383

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1515628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712534400000",
    "number": "1225546245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 ELWYN RD",
            "city": "ELWYN",
            "state": "PA",
            "postal_code": "190634622",
            "telephone_number": "610-891-7079",
            "fax_number": "610-891-2964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 HENRY AVE STE 401",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291121",
            "telephone_number": "267-673-3383"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 W Jefferson St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191223515",
            "country_code": "US",
            "telephone_number": "215-895-5588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ELWYN OF PENNSYLVANIA AND DELAWARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-11",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A",
        "authorized_official_last_name": "BUSCH",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "DIR.  OF CONTRACTING CREDENTIALING",
        "authorized_official_telephone_number": "445-206-3028"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "143430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000021240674",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elwyn Crisis Services Philadelphia",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.