Provider Demographics
NPI:1114729779
Name:WEINSTEIN, ELANA DANIELLE
Entity type:Individual
Prefix:
First Name:ELANA
Middle Name:DANIELLE
Last Name:WEINSTEIN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 POPLAR AVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-1064
Mailing Address - Country:US
Mailing Address - Phone:248-417-1204
Mailing Address - Fax:
Practice Address - Street 1:655 POPLAR AVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-1064
Practice Address - Country:US
Practice Address - Phone:248-417-1204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLSW.0009926201104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker