Healthcare Provider Details

I. General information

NPI: 1285739862
Provider Name (Legal Business Name): ELIZABETH TESKA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 CLERMONT ST SOCIAL WORK (122)
DENVER CO
80220-3808
US

IV. Provider business mailing address

8812 E AMHERST DR UNIT E
DENVER CO
80231-8205
US

V. Phone/Fax

Practice location:
  • Phone: 303-399-8020
  • Fax: 303-393-5076
Mailing address:
  • Phone: 303-696-9544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number146
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: