Provider Demographics
NPI:1477925592
Name:MCGROARTY, ELENA (LPC)
Entity Type:Individual
Prefix:
First Name:ELENA
Middle Name:
Last Name:MCGROARTY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2250 HWY 60 SUITE 1
Mailing Address - Street 2:
Mailing Address - City:GLOBE
Mailing Address - State:AZ
Mailing Address - Zip Code:85501
Mailing Address - Country:US
Mailing Address - Phone:928-402-8032
Mailing Address - Fax:928-402-9099
Practice Address - Street 1:210 E COTTONWOOD LN
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-2514
Practice Address - Country:US
Practice Address - Phone:520-836-1688
Practice Address - Fax:520-421-2708
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-28
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ15815101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZD00855298OtherDRIVERS LICENSE