Healthcare Provider Details

I. General information

NPI: 1396694428
Provider Name (Legal Business Name): AFFIRM COUNSELING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1136 E STUART ST STE 4101
FORT COLLINS CO
80525-1173
US

IV. Provider business mailing address

1281 E MAGNOLIA ST STE D
FORT COLLINS CO
80524-4794
US

V. Phone/Fax

Practice location:
  • Phone: 970-235-0011
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: TYLER WOODY
Title or Position: OWNER
Credential:
Phone: 970-235-0011