Provider Demographics
NPI:1851092910
Name:HOYACK, ELISA VERONICA (LCSW)
Entity Type:Individual
Prefix:
First Name:ELISA
Middle Name:VERONICA
Last Name:HOYACK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 W EMERALD AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-3410
Mailing Address - Country:US
Mailing Address - Phone:404-247-0209
Mailing Address - Fax:
Practice Address - Street 1:1355 S HIGLEY RD STE 113
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-4789
Practice Address - Country:US
Practice Address - Phone:480-339-7119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-207391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical