Healthcare Provider Details

I. General information

NPI: 1902701220
Provider Name (Legal Business Name): ELISA BROWSH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6525 GUNPARK DR STE 370-515
BOULDER CO
80301-3346
US

IV. Provider business mailing address

6525 GUNPARK DR STE 370-515
BOULDER CO
80301-3346
US

V. Phone/Fax

Practice location:
  • Phone: 303-578-9189
  • Fax:
Mailing address:
  • Phone: 303-578-9189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC.0025110
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: