Provider Demographics
NPI:1649554320
Name:WASSERMAN, ELIZABETH (LCSW, INHC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:WASSERMAN
Suffix:
Gender:F
Credentials:LCSW, INHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 FILLMORE ST UNIT 150
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-5001
Mailing Address - Country:US
Mailing Address - Phone:855-217-7205
Mailing Address - Fax:
Practice Address - Street 1:250 FILLMORE ST UNIT 150
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5001
Practice Address - Country:US
Practice Address - Phone:855-217-7205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-29
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY077037104100000X
CT73361041C0700X
CO17961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker