Healthcare Provider Details

I. General information

NPI: 1538756184
Provider Name (Legal Business Name): LONI K BEALL LPC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2020
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

343 W DRAKE RD STE 275
FORT COLLINS CO
80526-5110
US

IV. Provider business mailing address

2739 BIANCO DR
FORT COLLINS CO
80521-4917
US

V. Phone/Fax

Practice location:
  • Phone: 970-239-1033
  • Fax: 970-449-0591
Mailing address:
  • Phone: 970-239-1033
  • Fax: 970-239-1033

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 Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MRS. LONI BEALL
Title or Position: OWNER
Credential: LPC
Phone: 970-829-0761