Provider Demographics
NPI:1477074912
Name:DELACRUZ-JIRON, EVELYN (EDD, LMFT,)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:DELACRUZ-JIRON
Suffix:
Gender:F
Credentials:EDD, LMFT,
Other - Prefix:
Other - First Name:EVELYN
Other - Middle Name:
Other - Last Name:DELACRUZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:2265 W FORD PL
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80223-2501
Mailing Address - Country:US
Mailing Address - Phone:303-868-0509
Mailing Address - Fax:
Practice Address - Street 1:6795 E TENNESSEE AVE STE 620
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-1697
Practice Address - Country:US
Practice Address - Phone:303-868-0509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-06
Last Update Date:2017-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMFT.0001389101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health