Provider Demographics
NPI:1952061053
Name:POWERS, EVAN (LPCC)
Entity Type:Individual
Prefix:
First Name:EVAN
Middle Name:
Last Name:POWERS
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1312 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-4314
Mailing Address - Country:US
Mailing Address - Phone:303-667-6691
Mailing Address - Fax:
Practice Address - Street 1:1401 S TAFT AVE STE 206
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-6962
Practice Address - Country:US
Practice Address - Phone:970-775-8456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-30
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0017749101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health