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General NPI Number Information
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NPI Number | 1154618627
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Entity Type | Individual
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Provider Name | ERIC STEVENS
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Gender | Male
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Dates
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Enumeration Date | 07/06/2011
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Last Update Date | 02/16/2024
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Provider Practice Location Address
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Address Line | 10465 MELODY DR STE 101
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City | NORTHGLENN
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State | CO
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Zip | 80234-4124
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Country | US
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Telephone | 303-491-1981
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Fax |
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Provider Business Mailing Address
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Address Line | 10465 MELODY DR STE 101
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City | NORTHGLENN
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State | CO
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Zip | 80234-4124
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Country | US
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Telephone | 303-491-1981
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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 | LPC-9051
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC.0019971
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC.0019971
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC-2215
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License Number State | WY
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