Provider Demographics
NPI:1497900567
Name:MCDOW, ELLEN NORDSKOG (MA, LPC)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:NORDSKOG
Last Name:MCDOW
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:NORDSKOG
Other - Last Name:MUNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LAC
Mailing Address - Street 1:2563 S VAL VISTA DR STE 108
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-6231
Mailing Address - Country:US
Mailing Address - Phone:480-448-1076
Mailing Address - Fax:
Practice Address - Street 1:2563 S VAL VISTA DR STE 108
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-6231
Practice Address - Country:US
Practice Address - Phone:480-448-1076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-17
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-13405101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor