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NPI Code Detail

MEDICARE: MS. NANCY MARIE FORNEY LPC

MEDICARE:  MS. NANCY MARIE FORNEY  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
1101YM0800XMental Health CounselorLPC11903AZ
2101YM0800XMental Health Counselor0015269CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1LPC11903OTHERAZTHERAPIST
20015269OTHERCOTHERAPIST

General Provider Information

NPI Number : 1679643977
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. NANCY MARIE FORNEY LPC
Provider Business Mailing Address
First Line : 8242 BURL WOOD DR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80908-1485
Country : US
Telephone Number : 719-301-0290
Fax Number : 719-426-9776
Provider Business Practice Location Address
First Line : 3230 E WOODMEN RD STE 110B
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80920-8502
Country : US
Telephone Number : 719-301-0290
Fax Number : 719-426-9776
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2006
Last Update Date : 05/08/2021

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Directions to “ MS. NANCY MARIE FORNEY LPC” Practice Location

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