Healthcare Provider Details

I. General information

NPI: 1053180828
Provider Name (Legal Business Name): KEVIN CARLSTEAD LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2023
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1731 E 16TH AVE
DENVER CO
80218-1628
US

IV. Provider business mailing address

1731 E 16TH AVE
DENVER CO
80218-1628
US

V. Phone/Fax

Practice location:
  • Phone: 720-639-7724
  • Fax:
Mailing address:
  • Phone: 720-696-0039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT.0003028
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC.0021800
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: