Provider Demographics
NPI:1497928014
Name:COLORADO COALITION FOR THE HOMELESS
Entity Type:Organization
Organization Name:COLORADO COALITION FOR THE HOMELESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PSYCHIATRY
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:COOKSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-285-5290
Mailing Address - Street 1:2111 CHAMPA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-2529
Mailing Address - Country:US
Mailing Address - Phone:303-293-2217
Mailing Address - Fax:303-293-2309
Practice Address - Street 1:2111 CHAMPA ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-2529
Practice Address - Country:US
Practice Address - Phone:303-293-2217
Practice Address - Fax:303-293-2309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-03
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO50846363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO34404741Medicaid
COP27174Medicare PIN