Provider Demographics
NPI:1396509287
Name:ENLIGHTENED LEARNING CONSULTING LLC
Entity type:Organization
Organization Name:ENLIGHTENED LEARNING CONSULTING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:PEDERSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-746-1561
Mailing Address - Street 1:1033 FIREFLOWER CIR
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-5613
Mailing Address - Country:US
Mailing Address - Phone:303-746-1561
Mailing Address - Fax:
Practice Address - Street 1:1033 FIREFLOWER CIR
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-5613
Practice Address - Country:US
Practice Address - Phone:303-746-1561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty