Provider Demographics
NPI:1093401184
Name:WICKS-ARSHACK, ELIZA KATE (LCSW)
Entity type:Individual
Prefix:
First Name:ELIZA
Middle Name:KATE
Last Name:WICKS-ARSHACK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38169 US HIGHWAY 50
Mailing Address - Street 2:
Mailing Address - City:GUNNISON
Mailing Address - State:CO
Mailing Address - Zip Code:81230-8730
Mailing Address - Country:US
Mailing Address - Phone:917-664-6582
Mailing Address - Fax:
Practice Address - Street 1:38169 US HIGHWAY 50
Practice Address - Street 2:
Practice Address - City:GUNNISON
Practice Address - State:CO
Practice Address - Zip Code:81230-8730
Practice Address - Country:US
Practice Address - Phone:917-664-6582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-12
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099304501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical