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General NPI Number Information
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NPI Number | 1679948400
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Entity Type | Individual
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Provider Name | CONNOR ELIZABETH MCGREW LPC
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Gender | Female
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Dates
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Enumeration Date | 12/04/2015
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Last Update Date | 11/10/2022
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Provider Practice Location Address
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Address Line | 3015 HIGHWAY 956
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City | ETHEL
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State | LA
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Zip | 70730-4520
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Country | US
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Telephone | 225-681-8407
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Fax |
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Provider Business Mailing Address
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Address Line | 9171 COCKERHAM RD STE 102
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City | DENHAM SPRINGS
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State | LA
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Zip | 70726-2255
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Country | US
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Telephone | 225-681-8417
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 7816
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License Number State | LA
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