Provider Demographics
NPI:1053180828
Name:CARLSTEAD, KEVIN (MFTC, LPCC)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:CARLSTEAD
Suffix:
Gender:M
Credentials:MFTC, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 N HUMBOLDT ST APT 1103
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-2463
Mailing Address - Country:US
Mailing Address - Phone:858-245-2498
Mailing Address - Fax:
Practice Address - Street 1:1731 E 16TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1628
Practice Address - Country:US
Practice Address - Phone:720-639-7724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-21
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0014578101YM0800X
CO0021800101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health