Healthcare Provider Details

I. General information

NPI: 1548715584
Provider Name (Legal Business Name): ENB COLLECTIVE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2016
Last Update Date: 08/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4031 MEADE ST
DENVER CO
80211-1945
US

IV. Provider business mailing address

4031 MEADE ST
DENVER CO
80211-1945
US

V. Phone/Fax

Practice location:
  • Phone: 303-995-6948
  • Fax:
Mailing address:
  • Phone: 303-995-6948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number9920795
License Number StateCO

VIII. Authorized Official

Name: ELISSA BERLINGER
Title or Position: OWNER
Credential: LCSW
Phone: 303-995-6948