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NPI 1750700985

NPI 1750700985 : EDELTRAUD ARCHINGER LCSW : BERTHOUD, CO

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General NPI Number Information
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    NPI Number           |    1750700985
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    Entity Type          |    Individual 
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    Provider Name        |    EDELTRAUD ARCHINGER LCSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/15/2014
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    Last Update Date     |    07/29/2021
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Provider Practice Location Address
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    Address Line         |    328 MASSACHUSETTS AVE 
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    City                 |    BERTHOUD
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    State                |    CO
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    Zip                  |    80513-5003
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    Country              |    US
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    Telephone            |    303-847-9683
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 1273 
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    City                 |    BERTHOUD
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    State                |    CO
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    Zip                  |    80513-2273
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    Country              |    US
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    Telephone            |    303-847-9683
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    Fax                  |    
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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        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    CSW.09924176
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    License Number State |    CO
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Taxonomy #2
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    
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    License Number State |    
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