Provider Demographics
NPI:1982928669
Name:EBERHARDT, EVA KATHARINE (LPC CACIII NCC)
Entity Type:Individual
Prefix:MS
First Name:EVA
Middle Name:KATHARINE
Last Name:EBERHARDT
Suffix:
Gender:F
Credentials:LPC CACIII NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:FORT MORGAN
Mailing Address - State:CO
Mailing Address - Zip Code:80701-2544
Mailing Address - Country:US
Mailing Address - Phone:970-867-2125
Mailing Address - Fax:970-867-4495
Practice Address - Street 1:607 MAPLE ST
Practice Address - Street 2:
Practice Address - City:FORT MORGAN
Practice Address - State:CO
Practice Address - Zip Code:80701-2544
Practice Address - Country:US
Practice Address - Phone:970-867-2125
Practice Address - Fax:970-867-4495
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-24
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2936101YM0800X
CO4259101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health