Provider Demographics
NPI:1467747923
Name:ELA, REBECCA (LCSW)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:ELA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:BECKY
Other - Middle Name:
Other - Last Name:HARTSHORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:115 GRAND AVE, SUITE #2
Mailing Address - Street 2:ALL AMERICAN FAMILIES
Mailing Address - City:DELTA
Mailing Address - State:CO
Mailing Address - Zip Code:81416-2017
Mailing Address - Country:US
Mailing Address - Phone:970-874-0464
Mailing Address - Fax:970-874-0464
Practice Address - Street 1:115 GRAND AVE, SUITE #2
Practice Address - Street 2:ALL AMERICAN FAMILIES
Practice Address - City:DELTA
Practice Address - State:CO
Practice Address - Zip Code:81416-2017
Practice Address - Country:US
Practice Address - Phone:970-874-0464
Practice Address - Fax:970-874-0464
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.000016571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO486918ZUFPOtherMEDICARE B PTAN FOR ALL AMERICAN FAMILIES
P01641916OtherRAILROAD WORKERS MEDICARE FOR ALL AMERICAN FAMILIES