Provider Demographics
NPI:1003136995
Name:SPROLE, ELEN MICHELE (LCPC)
Entity type:Individual
Prefix:MS
First Name:ELEN
Middle Name:MICHELE
Last Name:SPROLE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2852 KINKNOCKIE WAY
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89044-0250
Mailing Address - Country:US
Mailing Address - Phone:702-499-3456
Mailing Address - Fax:
Practice Address - Street 1:2852 KINKNOCKIE WAY
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89044-0250
Practice Address - Country:US
Practice Address - Phone:702-499-3456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00009042101YM0800X
NVCP0006101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health