MEDICARE: ELIZABETH ANN WEIR MSW, LICSW

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	1041C0700X	Clinical Social Worker	16114	MN
2	1041C0700X	Clinical Social Worker	CSW.09923344	CO

General Provider Information

NPI Number	:	1578668091
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH ANN WEIR MSW, LICSW

Provider Business Mailing Address
First Line	:	10350 E DAKOTA AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80247-1314
Country	:	US
Telephone Number	:	303-338-4545
Fax Number	:

Provider Business Practice Location Address
First Line	:	2500 S HAVANA ST
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80014-1618
Country	:	US
Telephone Number	:	303-338-4545
Fax Number	:

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

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	04/11/2023

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