Healthcare Provider Details

I. General information

NPI: 1174460869
Provider Name (Legal Business Name): MRS. ELISABETH DURSTON CONNOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2209 JULIAN ST
DENVER CO
80211-5026
US

IV. Provider business mailing address

2209 JULIAN ST
DENVER CO
80211-5026
US

V. Phone/Fax

Practice location:
  • Phone: 240-418-0410
  • Fax:
Mailing address:
  • Phone: 240-418-0410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: