Healthcare Provider Details

I. General information

NPI: 1730145806
Provider Name (Legal Business Name): CATHERINE E ELIASEN LCSW, CACII
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 06/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

267 6TH STREET
MEEKER CO
81641
US

IV. Provider business mailing address

715 HORIZON DR STE 225
GRAND JUNCTION CO
81506-8700
US

V. Phone/Fax

Practice location:
  • Phone: 970-878-5112
  • Fax: 970-878-4315
Mailing address:
  • Phone: 970-683-7107
  • Fax: 970-683-7167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number991411
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number7800
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: