Healthcare Provider Details

I. General information

NPI: 1225438559
Provider Name (Legal Business Name): CHANTAL MCCARTHY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2014
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1644 S COLLEGE AVE
FORT COLLINS CO
80525-1007
US

IV. Provider business mailing address

1644 S COLLEGE AVE
FORT COLLINS CO
80525-1007
US

V. Phone/Fax

Practice location:
  • Phone: 970-221-0999
  • Fax: 970-221-0999
Mailing address:
  • Phone: 970-221-0999
  • Fax: 970-221-0999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0015652
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: