Provider Demographics
NPI:1386272953
Name:KEATEN, CARLY ELIZABETH (LPC)
Entity type:Individual
Prefix:
First Name:CARLY
Middle Name:ELIZABETH
Last Name:KEATEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2137 N DOWNING ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-5210
Mailing Address - Country:US
Mailing Address - Phone:303-887-2447
Mailing Address - Fax:
Practice Address - Street 1:1501 ALBION ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-1028
Practice Address - Country:US
Practice Address - Phone:303-399-4890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-30
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0016116101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty