Provider Demographics
NPI:1942196340
Name:SCROGGINS, ELAINE
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:SCROGGINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LAINEY
Other - Middle Name:
Other - Last Name:SCROGGINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1540 W EDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46217-9648
Mailing Address - Country:US
Mailing Address - Phone:317-561-1888
Mailing Address - Fax:
Practice Address - Street 1:1540 W EDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46217-9648
Practice Address - Country:US
Practice Address - Phone:317-561-1888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22003230A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist