Provider Demographics
NPI:1386267359
Name:MERIDA, EVAN (LPC)
Entity type:Individual
Prefix:
First Name:EVAN
Middle Name:
Last Name:MERIDA
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1978 W 67TH PL
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80221-2620
Mailing Address - Country:US
Mailing Address - Phone:303-928-0163
Mailing Address - Fax:
Practice Address - Street 1:899 N LOGAN ST STE 309
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-3155
Practice Address - Country:US
Practice Address - Phone:303-928-0163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-25
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty