Organization
ACTUALIZE BEHAVIOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH EARNEST LCSW (DIRECTOR)
(720) 775-0151
Entity
Organization
Contact information
Practice address
5575 S SYCAMORE ST STE 108, LITTLETON, CO 80120-1141
(720) 775-0151
Mailing address
9249 S BROADWAY STE 811, HIGHLANDS RANCH, CO 80129-5690
(720) 775-0151
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09255346
—
CO
Enumeration date
05/21/2021
Last updated
07/01/2021
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