MEDICARE: CARTER GLENN HOLMES LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LPC.0020882	CO

General Provider Information

NPI Number	:	1679319099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARTER GLENN HOLMES LPC

Provider Business Mailing Address
First Line	:	343 W DRAKE RD STE 275
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-6317
Country	:	US
Telephone Number	:	970-682-3331
Fax Number	:

Provider Business Practice Location Address
First Line	:	1221 E ELIZABETH ST STE 3
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-4066
Country	:	US
Telephone Number	:	970-682-1337
Fax Number	:	855-461-3393

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/04/2024
Last Update Date	:	12/03/2025

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