Provider Demographics
NPI:1912164344
Name:MCELROY, LINDA PROVUS (PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:PROVUS
Last Name:MCELROY
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 1:2233 NW 41ST ST
Mailing Address - Street 2:SUITE 200F
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-7471
Mailing Address - Country:US
Mailing Address - Phone:352-378-5278
Mailing Address - Fax:352-378-5270
Practice Address - Street 1:2233 NW 41ST ST
Practice Address - Street 2:SUITE 200F
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-7471
Practice Address - Country:US
Practice Address - Phone:352-378-5278
Practice Address - Fax:352-378-5270
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-22
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH0001676101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health