MEDICARE: ELIO THEODORE CARBERRY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician		CO

General Provider Information

NPI Number	:	1164385050
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIO THEODORE CARBERRY

Provider Business Mailing Address
First Line	:	1330 S POTOMAC ST
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80012-4527
Country	:	US
Telephone Number	:	720-845-6675
Fax Number	:

Provider Business Practice Location Address
First Line	:	1330 S POTOMAC ST STE 11
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80012-4527
Country	:	US
Telephone Number	:	720-845-6675
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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Directions to “ ELIO THEODORE CARBERRY ” Practice Location

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