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  7. NPI Record 1245381938

ELIZABETH YAEGER
Complete NPI Record 1245381938
Counselor - Mental Health in Pueblo, CO

NPI Status: Active since January 16, 2007

Contact Information

417 W 13TH ST
PUEBLO, CO
ZIP 81003
Phone: (719) 544-0877
Fax: (719) 544-2033

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider First Line Business Mailing Address
  6. Provider Business Mailing Address City Name
  7. Provider Business Mailing Address State Name
  8. Provider Business Mailing Address Postal Code
  9. Provider Business Mailing Address Country Code If outside U S
  10. Provider Business Mailing Address Telephone Number
  11. Provider Business Mailing Address Fax Number
  12. Provider First Line Business Practice Location Address
  13. Provider Business Practice Location Address City Name
  14. Provider Business Practice Location Address State Name
  15. Provider Business Practice Location Address Postal Code
  16. Provider Business Practice Location Address Country Code If outside U S
  17. Provider Business Practice Location Address Telephone Number
  18. Provider Business Practice Location Address Fax Number
  19. Provider Enumeration Date
  20. Last Update Date
  21. Authorized Official Last Name
  22. Authorized Official First Name
  23. Authorized Official Title or Position
  24. Authorized Official Telephone Number
  25. Healthcare Provider Taxonomy Code 1
  26. Provider License Number 1
  27. Provider License Number State Code 1
  28. Healthcare Provider Primary Taxonomy Switch 1
  29. Other Provider Identifier 1
  30. Other Provider Identifier Type Code 1
  31. Other Provider Identifier State 1
  32. Is Organization Subpart
  33. Authorized Official Credential Text
  34. Healthcare Provider Taxonomy Group 1

Complete NPI Dataset

This page represents the complete record for NPI 1245381938. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1245381938
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Entity Type Code: 2
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Employer Identification Number EIN: UNAVAIL
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider First Line Business Mailing Address: 417 W 13TH ST
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Mailing Address City Name: PUEBLO
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Mailing Address State Name: CO
The city name in the location address of the provider being identified.
Provider Business Mailing Address Postal Code: 810032703
The State code in the location of the provider being identified.
Provider Business Mailing Address Country Code If outside U S : US
The city name in the location address of the provider being identified.
Provider Business Mailing Address Telephone Number: 7195440877
The State code in the location of the provider being identified.
Provider Business Mailing Address Fax Number: 7195442033
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider First Line Business Practice Location Address: 417 W 13TH ST
The country code in the location address of the provider being identified.
Provider Business Practice Location Address City Name: PUEBLO
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address State Name: CO
The date the provider was assigned a unique identifier (assigned an NPI).
Provider Business Practice Location Address Postal Code: 810032703
The date that a record was last updated or changed.
Provider Business Practice Location Address Country Code If outside U S : US
The code designating the provider’s gender if the provider is a person.
Provider Business Practice Location Address Telephone Number: 7195440877
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider Business Practice Location Address Fax Number: 7195442033
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider Enumeration Date: 1/16/2007
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Last Update Date: 8/22/2020
Authorized Official Last Name: YAEGER
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
Authorized Official First Name: ELIZABETH
Authorized Official Title or Position: PSYCHOTHERAPIST
The title or position of the authorized official.
Authorized Official Telephone Number: 7195440877
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 101YM0800X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: 1607
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1: CO
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: Y
Other Provider Identifier 1: 136152
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 1: 05
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1: CO
Is Organization Subpart: N
Authorized Official Credential Text: LPC
Healthcare Provider Taxonomy Group 1: 193400000X SINGLE SPECIALTY GROUP