Provider Demographics
NPI:1932539582
Name:ELIZABETH RASZKA CONSULTING
Entity Type:Organization
Organization Name:ELIZABETH RASZKA CONSULTING
Other - Org Name:COLORADO BEHAVIOR AND LEARNING GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:OSTENDORF
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:719-649-5037
Mailing Address - Street 1:7011 CAMPUS DR STE 205
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-3104
Mailing Address - Country:US
Mailing Address - Phone:719-649-5037
Mailing Address - Fax:719-368-8399
Practice Address - Street 1:7011 CAMPUS DR STE 205
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3104
Practice Address - Country:US
Practice Address - Phone:719-649-5037
Practice Address - Fax:719-368-8399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-18
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-13-14747103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO38800063Medicaid
CO1209559OtherCAQH
CO1-13-14747OtherBACB