Provider Demographics
NPI:1629492905
Name:GROSCHWITZ, ELYSIA TARYN
Entity Type:Individual
Prefix:
First Name:ELYSIA
Middle Name:TARYN
Last Name:GROSCHWITZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELYSIA
Other - Middle Name:TARYN
Other - Last Name:FOLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:PO BOX 31
Mailing Address - Street 2:
Mailing Address - City:LUXOR
Mailing Address - State:PA
Mailing Address - Zip Code:15662-0031
Mailing Address - Country:US
Mailing Address - Phone:724-787-8344
Mailing Address - Fax:
Practice Address - Street 1:4963 STATE ROUTE 30 STE 204
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-2343
Practice Address - Country:US
Practice Address - Phone:724-244-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-07
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011007101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional