Healthcare Provider Details

I. General information

NPI: 1770988719
Provider Name (Legal Business Name): SABRINA CONNELLY LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2014
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2625 REDWING RD STE 370
FORT COLLINS CO
80526-6314
US

IV. Provider business mailing address

2901 INDIGO CIR N
FORT COLLINS CO
80528-9592
US

V. Phone/Fax

Practice location:
  • Phone: 904-419-9189
  • Fax: 904-456-0852
Mailing address:
  • Phone: 904-625-3162
  • Fax: 904-456-0852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPC.0020555
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH12917
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: