Provider Demographics
NPI:1013134980
Name:ELLIAS, MAGGIE LEVIN (MSS)
Entity Type:Individual
Prefix:MRS
First Name:MAGGIE
Middle Name:LEVIN
Last Name:ELLIAS
Suffix:
Gender:F
Credentials:MSS
Other - Prefix:MISS
Other - First Name:MAGGIE
Other - Middle Name:BETH
Other - Last Name:LEVIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSS
Mailing Address - Street 1:595 PAISLEY DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-8263
Mailing Address - Country:US
Mailing Address - Phone:719-540-2204
Mailing Address - Fax:
Practice Address - Street 1:5540 TECH CENTER DR
Practice Address - Street 2:SUITE 203
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-2331
Practice Address - Country:US
Practice Address - Phone:719-548-0100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical