Provider Demographics
NPI:1134945983
Name:ELANVITAL CREATIVE JOURNEYS COUNSELING
Entity type:Organization
Organization Name:ELANVITAL CREATIVE JOURNEYS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ELAAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUDNO
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:720-556-3074
Mailing Address - Street 1:PO BOX 386
Mailing Address - Street 2:
Mailing Address - City:NIWOT
Mailing Address - State:CO
Mailing Address - Zip Code:80544-3562
Mailing Address - Country:US
Mailing Address - Phone:720-556-3074
Mailing Address - Fax:866-757-5778
Practice Address - Street 1:6964 N 79TH STREET
Practice Address - Street 2:#4
Practice Address - City:NIWOT
Practice Address - State:CO
Practice Address - Zip Code:80503
Practice Address - Country:US
Practice Address - Phone:720-556-3074
Practice Address - Fax:866-757-5778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-26
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty