Provider Demographics
NPI:1548715584
Name:ENB COLLECTIVE, PLLC
Entity type:Organization
Organization Name:ENB COLLECTIVE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:303-995-6948
Mailing Address - Street 1:4031 MEADE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-1945
Mailing Address - Country:US
Mailing Address - Phone:303-995-6948
Mailing Address - Fax:
Practice Address - Street 1:4031 MEADE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-1945
Practice Address - Country:US
Practice Address - Phone:303-995-6948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-19
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO99207951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty