Provider Demographics
NPI:1700964731
Name:TAEUBERT, ELIZABETH ANN (LCSW)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:TAEUBERT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2918 FLORENCE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80238-2969
Mailing Address - Country:US
Mailing Address - Phone:720-949-1194
Mailing Address - Fax:720-519-0315
Practice Address - Street 1:360 S MONROE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-3705
Practice Address - Country:US
Practice Address - Phone:720-949-1194
Practice Address - Fax:720-519-0315
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9929091041C0700X
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical