Provider Demographics
NPI:1255011300
Name:EBERT, CARLY (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:CARLY
Middle Name:
Last Name:EBERT
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2695 ROCKY MOUNTAIN AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9071
Mailing Address - Country:US
Mailing Address - Phone:970-624-1110
Mailing Address - Fax:970-490-4156
Practice Address - Street 1:175 INVERNESS DR W STE 100
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-5066
Practice Address - Country:US
Practice Address - Phone:303-694-3333
Practice Address - Fax:303-694-9666
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-24
Last Update Date:2025-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0008021225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist