Healthcare Provider Details

I. General information

NPI: 1306919220
Provider Name (Legal Business Name): ELIZABETH EILEEN NEVERS L.P.C., L.C.M.F.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EILEEN NEVERS L.P.C., L.C.M.F.T.

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 01/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4790 TABLE MESA DR
BOULDER CO
80305-5600
US

IV. Provider business mailing address

8034 ANCHOR DR
LONGMONT CO
80504-7769
US

V. Phone/Fax

Practice location:
  • Phone: 720-428-9240
  • Fax: 913-438-3881
Mailing address:
  • Phone: 913-206-3830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number042
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0013512
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: