Basic Information
| Provider Information | |||||||||
| NPI: | 1851746523 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EGELHOFF | ||||||||
| FirstName: | DARLENE | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1208 | ||||||||
| Address2: | |||||||||
| City: | MONTROSE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 814021208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9702523200 | ||||||||
| FaxNumber: | 9702523208 | ||||||||
| Practice Location | |||||||||
| Address1: | 407 4TH ST | ||||||||
| Address2: | #1 | ||||||||
| City: | CRESTED BUTTE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 81224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9702099086 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/29/2016 | ||||||||
| LastUpdateDate: | 10/21/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | ACC0020873 | CO | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YP2500X | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.