Healthcare Provider Details

I. General information

NPI: 1972033686
Provider Name (Legal Business Name): ANYA GARVEY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2017
Last Update Date: 08/01/2021
Certification Date: 08/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 38TH ST STE 100E
BOULDER CO
80301-2624
US

IV. Provider business mailing address

350 MERCATOR AVE
LAFAYETTE CO
80026-3112
US

V. Phone/Fax

Practice location:
  • Phone: 720-773-2393
  • Fax:
Mailing address:
  • Phone: 720-468-6171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number12662
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0012662
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: