Healthcare Provider Details

I. General information

NPI: 1285956359
Provider Name (Legal Business Name): DEBORAH LOUISE FENTON-NICHOLS LPC, LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2010
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E. BOARDWALK DRIVE BUILDING 6A
FORT COLLINS CO
80525-3093
US

IV. Provider business mailing address

PO BOX 2124
FORT COLLINS CO
80522-2124
US

V. Phone/Fax

Practice location:
  • Phone: 970-443-1038
  • Fax:
Mailing address:
  • Phone: 970-443-1038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5358
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number332
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: