Healthcare Provider Details

I. General information

NPI: 1447186903
Provider Name (Legal Business Name): KEEN JOURNEY THERAPY/COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 MAPLE ST UNIT 102
FORT COLLINS CO
80521-2077
US

IV. Provider business mailing address

94 EVANS ST
SEVERANCE CO
80550-2642
US

V. Phone/Fax

Practice location:
  • Phone: 970-534-8677
  • Fax:
Mailing address:
  • Phone: 970-534-8677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: KEIRA LISBETH OLIVAS
Title or Position: OWNER
Credential: MA, LPC, LMFT
Phone: 970-534-8677