MEDICARE: ELISABETH CROSS MA, LPC, NCC

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	LPC.0016042	CO

General Provider Information

NPI Number	:	1518599208
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELISABETH CROSS MA, LPC, NCC

Provider Business Mailing Address
First Line	:	4177 S MOBILE CIR APT B
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80013-5620
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5201 E WARREN AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-5144
Country	:	US
Telephone Number	:	720-295-7887
Fax Number	:

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

Provider Enumeration Date	:	02/10/2020
Last Update Date	:	02/10/2020

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