Provider Demographics
NPI:1881069672
Name:BRANDON, ELIZABETH ELDRIDGE (LMFT, CACII, CHT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ELDRIDGE
Last Name:BRANDON
Suffix:
Gender:F
Credentials:LMFT, CACII, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 E HARVARD ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-1735
Mailing Address - Country:US
Mailing Address - Phone:970-305-1505
Mailing Address - Fax:
Practice Address - Street 1:219 W MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80521-2926
Practice Address - Country:US
Practice Address - Phone:970-829-7391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-06
Last Update Date:2015-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACB.0007903101YA0400X
COMFT.0000599106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)