Healthcare Provider Details

I. General information

NPI: 1487590931
Provider Name (Legal Business Name): ELIZABETH FLEAGLE PSYD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 GARDEN CTR
BROOMFIELD CO
80020-7087
US

IV. Provider business mailing address

80 GARDEN CTR STE 140
BROOMFIELD CO
80020-1790
US

V. Phone/Fax

Practice location:
  • Phone: 720-515-7295
  • Fax:
Mailing address:
  • Phone: 720-515-7295
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. ELIZABETH FLEAGLE
Title or Position: OWNER AND DIRECTOR
Credential: PSYD
Phone: 720-515-7295