Provider Demographics
NPI:1932850104
Name:GROGAN, ANGELAN M (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:ANGELAN
Middle Name:M
Last Name:GROGAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10505 POWER DR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033-4718
Mailing Address - Country:US
Mailing Address - Phone:317-371-7762
Mailing Address - Fax:
Practice Address - Street 1:10505 POWER DR
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46033-4718
Practice Address - Country:US
Practice Address - Phone:317-371-7762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39004001A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health