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General NPI Number Information
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NPI Number | 1417135013
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Entity Type | Individual
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Provider Name | ELENA K MOGENSEN MSW
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Gender | Female
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Dates
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Enumeration Date | 02/06/2008
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Last Update Date | 10/27/2023
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Provider Practice Location Address
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Address Line | 685 MAIN ST. STE. 5-B
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City | MEEKER
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State | CO
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Zip | 81641
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Country | US
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Telephone | 970-878-9935
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Fax | 970-878-9970
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Provider Business Mailing Address
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Address Line | PO BOX 777
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City | MEEKER
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State | CO
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Zip | 81641-0777
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Country | US
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Telephone | 970-878-9935
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Fax | 970-878-9970
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 988005
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License Number State | CO
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