Healthcare Provider Details

I. General information

NPI: 1144379405
Provider Name (Legal Business Name): KAREN HASTINGS MCGROERTY LPCMH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12649 DUPONT BLVD
ELLENDALE DE
19941-3307
US

IV. Provider business mailing address

110 N PINE ST
SEAFORD DE
19973-3320
US

V. Phone/Fax

Practice location:
  • Phone: 302-422-1530
  • Fax: 302-422-1534
Mailing address:
  • Phone: 302-629-8294
  • Fax: 302-628-1711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC0000374
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: