Provider Demographics
NPI:1417758806
Name:KROLL, LAURA ELISA (LMSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ELISA
Last Name:KROLL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14794 W SAND HILLS RD
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85387-1962
Mailing Address - Country:US
Mailing Address - Phone:714-987-8289
Mailing Address - Fax:
Practice Address - Street 1:9880 N 77TH AVE
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85345-6667
Practice Address - Country:US
Practice Address - Phone:602-935-5154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-21
Last Update Date:2025-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-23190104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker