Provider Demographics
NPI:1063722098
Name:GENEREUX, ELIZABETH CLAIRE (MSW, LSW)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:CLAIRE
Last Name:GENEREUX
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:LIBBY
Other - Middle Name:
Other - Last Name:GENEREUX
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 40
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81602-0040
Mailing Address - Country:US
Mailing Address - Phone:970-945-2241
Mailing Address - Fax:970-945-5523
Practice Address - Street 1:137 HOWARD ST
Practice Address - Street 2:
Practice Address - City:EAGLE
Practice Address - State:CO
Practice Address - Zip Code:81631
Practice Address - Country:US
Practice Address - Phone:970-328-6969
Practice Address - Fax:970-328-6329
Is Sole Proprietor?:No
Enumeration Date:2010-10-08
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO836104100000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker