Healthcare Provider Details

I. General information

NPI: 1316169691
Provider Name (Legal Business Name): BARBARA ELLMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4770 E ILIFF AVE SUITE 106
DENVER CO
80222-6061
US

IV. Provider business mailing address

4770 E ILIFF AVE SUITE 106
DENVER CO
80222-6061
US

V. Phone/Fax

Practice location:
  • Phone: 303-770-1885
  • Fax: 303-942-5757
Mailing address:
  • Phone: 303-770-1885
  • Fax: 303-942-5757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number991573
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: