Healthcare Provider Details

I. General information

NPI: 1609572494
Provider Name (Legal Business Name): ALYSSA ESPOSITO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2023
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

363 W DRAKE RD STE 1
FORT COLLINS CO
80526-2882
US

IV. Provider business mailing address

729 REMINGTON ST
FORT COLLINS CO
80524-3332
US

V. Phone/Fax

Practice location:
  • Phone: 970-484-8427
  • Fax: 970-482-8713
Mailing address:
  • Phone: 970-484-8427
  • Fax: 970-482-8713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09928990
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: