Basic Information
| Provider Information | |||||||||
| NPI: | 1346815099 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ELIZABETH RASZKA CONSULTING | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2920 N ACADEMY BLVD STE 210 | ||||||||
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| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809175369 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7194664809 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5910 GALLEY RD | ||||||||
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| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809153736 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7193090119 | ||||||||
| FaxNumber: | 7193688399 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/25/2021 | ||||||||
| LastUpdateDate: | 05/25/2021 | ||||||||
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| AuthorizedOfficialLastName: | OSTENDORF | ||||||||
| AuthorizedOfficialFirstName: | ELIZABETH | ||||||||
| AuthorizedOfficialMiddleName: | MARY | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 7196495037 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | ELIZABETH RASZKA CONSULTING | ||||||||
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| NPICertificationDate: | 05/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106E00000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | 106S00000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | 103K00000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.