Healthcare Provider Details

I. General information

NPI: 1073014320
Provider Name (Legal Business Name): ELIZABETH SUZANNE BANEY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2018
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1667 COLE BLVD STE 290
LAKEWOOD CO
80401-3310
US

IV. Provider business mailing address

1667 COLE BLVD STE 290
LAKEWOOD CO
80401-3310
US

V. Phone/Fax

Practice location:
  • Phone: --
  • Fax:
Mailing address:
  • Phone: 888-664-4222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC.0018074
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: