Individual
JERRY LYNN MCELROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.ED,LISAC
Contact information
Practice address
1830 S ALMA SCHOOL RD, MESA, AZ 85210-3056
(480) 649-3352
(480) 649-3358
Mailing address
5811 W ELECTRA LN, GLENDALE, AZ 85310-3637
(480) 544-0411
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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