Healthcare Provider Details

I. General information

NPI: 1164359840
Provider Name (Legal Business Name): EAVAN CAROLINE COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3299 BRIGHTON BLVD UNIT 136
DENVER CO
80216-3863
US

IV. Provider business mailing address

3299 BRIGHTON BLVD UNIT 136
DENVER CO
80216-3863
US

V. Phone/Fax

Practice location:
  • Phone: 541-517-8030
  • Fax:
Mailing address:
  • Phone: 541-517-8030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: EAVAN CAROLINE MCKENZIE
Title or Position: MARRIAGE AND FAMILY THERAPIST
Credential: MA, LMFT
Phone: 541-517-8030