MEDICARE: ELISABETH ANNE TREGER

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	101YM0800X	Mental Health Counselor	LPCC.0021784	CO

General Provider Information

NPI Number	:	1316703523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELISABETH ANNE TREGER

Provider Business Mailing Address
First Line	:	3000 PALO PKWY
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80301-3699
Country	:	US
Telephone Number	:	312-404-2482
Fax Number	:

Provider Business Practice Location Address
First Line	:	3434 47TH ST STE 130
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80301-1802
Country	:	US
Telephone Number	:	312-404-2482
Fax Number	:

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

Provider Enumeration Date	:	02/26/2024
Last Update Date	:	02/26/2024

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Directions to “ ELISABETH ANNE TREGER ” Practice Location

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