Provider Demographics
NPI:1922530690
Name:ALLEN, ELENA (LISW-S)
Entity type:Individual
Prefix:
First Name:ELENA
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3382 PARIS BLVD
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-4260
Mailing Address - Country:US
Mailing Address - Phone:614-963-2731
Mailing Address - Fax:
Practice Address - Street 1:3382 PARIS BLVD
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-4260
Practice Address - Country:US
Practice Address - Phone:614-963-2731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-31
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COI.2002491-SUPV1041C0700X
OHI.20024911041C0700X
COCSW.099287131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1473276Medicaid