Look up the most recent NPI and PECOS records

Stacy Eldredge

Counselor

Behavioral Health & Social Service Providers

758 Main St, Carbondale, CO 81623-1947

PECOS Enrollment

Based on the most recent information from CMS, provider Stacy Eldredge does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1023503729
Provider Type
Individual
Full Name
Eldredge, Stacy
Gender
Female

Sole Proprietor
Yes
Enumeration Date
6/25/2018
Last Updated
6/25/2018

Contact Information

Practice Location

758 Main St, Carbondale, CO 81623-1947

(310) 344-4901

Unlisted Fax

Mailing Location

758 Main St, Carbondale, CO 81623-1947

(310) 344-4901

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YA0400X Primary	Description Counselor Behavioral Health & Social Service Providers	License ACB.0008316 Colorado

Provider Identifiers

ID	Description	Issuer
ID ACB.0008316	Description Other	Issuer STATE OF COLORADO Colorado

Stacy Eldredge

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Fedishen, Sarah Lizabeth

Lauf, Rodney Craig

Pew, Robert

Maxwell, Henry Garrett

Herrmann, Todd Evan

Bate, Stefan

Bell, Robert

Hermes, Joseph Walter

Haley, Marymike

Young, Patrick Whiting