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Individual
JERRY LYNN MCELROY
Active
Individual
JERRY LYNN MCELROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.ED,LISAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
SA-1559
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SA-1559
AZ BOARD OF BEHAVIORAL HEALTH EXAMINERS
AZ
Enumeration date
12/06/2017
Last updated
12/06/2017
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