Healthcare Provider Details
I. General information
NPI: 1366208027
Provider Name (Legal Business Name): EVOKE BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/21/2024
Last Update Date: 02/21/2024
Certification Date: 02/21/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2145 S CLERMONT ST
DENVER CO
80222-5006
US
IV. Provider business mailing address
4400 E EVANS AVE
DENVER CO
80222-5023
US
V. Phone/Fax
- Phone: 720-355-1081
- Fax: 866-817-1606
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QD1600X |
| Taxonomy | Developmental Disabilities Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
EMILY
WHITE
Title or Position: CEO
Credential: BCBA
Phone: 720-355-1066