Provider Demographics
NPI:1295905875
Name:MCELROY, KIMBERLY G (LPCC)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:G
Last Name:MCELROY
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41870 KALMIA ST
Mailing Address - Street 2:SUITE 155
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-8839
Mailing Address - Country:US
Mailing Address - Phone:949-282-8193
Mailing Address - Fax:951-678-9765
Practice Address - Street 1:41870 KALMIA ST
Practice Address - Street 2:SUITE 155
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-8839
Practice Address - Country:US
Practice Address - Phone:949-282-8193
Practice Address - Fax:951-678-9765
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-10
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPCC1101101YP2500X
OHE0000561 - SUPV101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
11817644OtherCAQH