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General NPI Number Information
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NPI Number | 1083428353
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Entity Type | Individual
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Provider Name | EVAN MASLAND CLARK LPCC
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Gender | Male
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Dates
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Enumeration Date | 02/05/2025
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 7720 E BELLEVIEW AVE STE B300
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-2615
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Country | US
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Telephone | 303-942-0512
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Fax |
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Provider Business Mailing Address
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Address Line | 1033 S CLARKSON ST
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City | DENVER
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State | CO
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Zip | 80209-4303
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Country | US
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Telephone | 502-572-9272
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPCC.0022632
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License Number State | CO
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