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General NPI Number Information
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NPI Number | 1982928669
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Entity Type | Individual
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Provider Name | EVA KATHARINE EBERHARDT LPC CACIII NCC
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Gender | Female
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Dates
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Enumeration Date | 03/24/2010
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Last Update Date | 11/03/2017
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Provider Practice Location Address
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Address Line | 607 MAPLE ST
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City | FORT MORGAN
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State | CO
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Zip | 80701-2544
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Country | US
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Telephone | 970-867-2125
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Fax | 970-867-4495
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Provider Business Mailing Address
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Address Line | 607 MAPLE ST
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City | FORT MORGAN
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State | CO
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Zip | 80701-2544
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Country | US
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Telephone | 970-867-2125
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Fax | 970-867-4495
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 2936
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 4259
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License Number State | CO
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