Provider Demographics
NPI:1891457503
Name:CHABIN, ELLEN ANNE
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:ANNE
Last Name:CHABIN
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 1:10618 STONE CREEK CT
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-2536
Mailing Address - Country:US
Mailing Address - Phone:720-244-8123
Mailing Address - Fax:
Practice Address - Street 1:10618 STONE CREEK CT
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-2536
Practice Address - Country:US
Practice Address - Phone:720-244-8123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-10
Last Update Date:2021-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC0017584101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional