Provider Demographics
NPI:1073014320
Name:BANEY, ELIZABETH SUZANNE
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:SUZANNE
Last Name:BANEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 W 122ND AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-3495
Mailing Address - Country:US
Mailing Address - Phone:888-664-4222
Mailing Address - Fax:
Practice Address - Street 1:1400 W 122ND AVE
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234-3495
Practice Address - Country:US
Practice Address - Phone:888-664-4222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-22
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health