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General NPI Number Information
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NPI Number | 1134930233
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Entity Type | Individual
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Provider Name | GAVIN HARRILL MA, MFTC
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Gender | Male
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Dates
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Enumeration Date | 01/17/2025
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 6273 W JEWELL AVE
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City | LAKEWOOD
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State | CO
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Zip | 80232-7113
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Country | US
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Telephone | 720-593-9932
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Fax |
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Provider Business Mailing Address
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Address Line | 6293 W JEWELL AVE UNIT 223
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City | LAKEWOOD
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State | CO
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Zip | 80232-7120
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Country | US
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Telephone | 720-979-7513
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 14659
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License Number State | CO
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