Provider Demographics
NPI:1528633948
Name:CARLEY, NEEVA
Entity type:Individual
Prefix:
First Name:NEEVA
Middle Name:
Last Name:CARLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6813 MCCLELLAN RD
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:CO
Mailing Address - Zip Code:80549-2282
Mailing Address - Country:US
Mailing Address - Phone:970-227-7160
Mailing Address - Fax:
Practice Address - Street 1:208 RACQUETTE DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-4851
Practice Address - Country:US
Practice Address - Phone:970-658-0690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-26
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLSW.0009923036101Y00000X
COCSW.099288551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCSW.09928855OtherLICENSED CLINICAL SOCIAL WORKER