Provider Demographics
NPI:1780842443
Name:HART, ELIZABETH JONES (LSW)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:JONES
Last Name:HART
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7944 ANTELOPE RIDGE PT
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-4716
Mailing Address - Country:US
Mailing Address - Phone:719-375-0609
Mailing Address - Fax:
Practice Address - Street 1:4090 CENTER PARK DR
Practice Address - Street 2:SUITE 2
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80916-4507
Practice Address - Country:US
Practice Address - Phone:303-371-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical