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STACY ELDREDGE
Addiction (Substance Use Disorder) >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1023503729
Individual Registrant: STACY ELDREDGE
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
758 MAIN ST CARBONDALE, CO 81623-1947 US
Tel: 310-344-4901 Fax: --
Tel: 310-344-4901 Fax: --
Contact information for business:
758 MAIN ST CARBONDALE, CO 81623-1947 US
Tel: 310-344-4901 Fax: --
Tel: 310-344-4901 Fax: --
Registration Information:
NPI: 1023503729
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 101YA0400X | Behavioral Health & Social Service Providers Counselor Addiction (Substance Use Disorder) | CO | ACB.0008316 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| STATE OF COLORADO | ACB.0008316 | CO | 01 |
