Healthcare Provider Details

I. General information

NPI: 1790387199
Provider Name (Legal Business Name): CHRISTOPHER SCOTT WILLIAMS MACP, LAC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2020
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

383 W DRAKE RD STE 102
FORT COLLINS CO
80526-2884
US

IV. Provider business mailing address

1114 W MULBERRY ST
FORT COLLINS CO
80521-3519
US

V. Phone/Fax

Practice location:
  • Phone: 970-829-1192
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberACD.0001921
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: