Healthcare Provider Details

I. General information

NPI: 1811245889
Provider Name (Legal Business Name): MRS. CLAIRE ELIASSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2012
Last Update Date: 08/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 E 7TH AVE
DENVER CO
80203
US

IV. Provider business mailing address

217 E 7TH AVE
DENVER CO
80203-3504
US

V. Phone/Fax

Practice location:
  • Phone: 303-900-8849
  • Fax:
Mailing address:
  • Phone: 303-900-8849
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number12092
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: