Individual
ELISELDA MATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, CAC III
Contact information
Practice address
2204 N EMERSON ST, DENVER, CO 80205-5127
(970) 424-4061
(872) 766-0965
Mailing address
2851 S PARKER RD STE 410, AURORA, CO 80014-2725
(720) 524-6874
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
7115
CO
101YP2500X
Professional Counselor
Primary
15407
CO
Other
Enumeration date
12/12/2012
Last updated
10/11/2023
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