Healthcare Provider Details

I. General information

NPI: 1932918166
Provider Name (Legal Business Name): EVAN ANDREW BROWN UNLICENSED THERAPIST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2025
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3169 S JOPLIN CT
AURORA CO
80013-1761
US

IV. Provider business mailing address

3169 S JOPLIN CT
AURORA CO
80013-1761
US

V. Phone/Fax

Practice location:
  • Phone: 720-616-8732
  • Fax:
Mailing address:
  • Phone: 720-616-8732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License NumberNLC.0110121
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: