Provider Demographics
NPI:1306215629
Name:ELLIOTT, DEBORAH B (LCSW)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:B
Last Name:ELLIOTT
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 1:509 SCOTT AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:WOODLAND PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80863-1293
Mailing Address - Country:US
Mailing Address - Phone:719-325-6250
Mailing Address - Fax:
Practice Address - Street 1:509 SCOTT AVE STE 100
Practice Address - Street 2:
Practice Address - City:WOODLAND PARK
Practice Address - State:CO
Practice Address - Zip Code:80863-1293
Practice Address - Country:US
Practice Address - Phone:719-325-6250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-16
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.00000440101YM0800X
COCSW000004401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health