Provider Demographics
NPI:1265427470
Name:MCGROGAN, CATHERINE ANN (PHD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:ANN
Last Name:MCGROGAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 303
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27907-0303
Mailing Address - Country:US
Mailing Address - Phone:252-338-8821
Mailing Address - Fax:252-338-8821
Practice Address - Street 1:301 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-4805
Practice Address - Country:US
Practice Address - Phone:252-338-8821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHSPP0956103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6000147Medicaid
NC04098OtherBCBS
NC94483OtherMEDCOST
NC6000147Medicaid