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General NPI Number Information
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NPI Number | 1619761129
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Entity Type | Individual
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Provider Name | LANI ELIZABETH GROGAN
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Gender | Female
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Dates
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Enumeration Date | 04/08/2025
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 5340 S QUEBEC ST STE 205N
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-1910
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Country | US
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Telephone | 708-271-7512
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Fax |
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Provider Business Mailing Address
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Address Line | 5500 MING AVE STE 410
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City | BAKERSFIELD
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State | CA
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Zip | 93309-4631
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 9079-123
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | .09931379
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License Number State | CO
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