Healthcare Provider Details

I. General information

NPI: 1215367164
Provider Name (Legal Business Name): SUMMER DAWN STOREY LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2013
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1537 RIVERSIDE AVE
FORT COLLINS CO
80524-4386
US

IV. Provider business mailing address

1537 RIVERSIDE AVE
FORT COLLINS CO
80524-4386
US

V. Phone/Fax

Practice location:
  • Phone: 970-310-3406
  • Fax: 888-965-4615
Mailing address:
  • Phone: 970-310-3406
  • Fax: 888-965-4615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC.0021352
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: