Healthcare Provider Details

I. General information

NPI: 1265350433
Provider Name (Legal Business Name): DELTA MIND COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3030 S COLLEGE AVE UNIT 200A
FORT COLLINS CO
80525-2557
US

IV. Provider business mailing address

3030 S COLLEGE AVE UNIT 200A
FORT COLLINS CO
80525-2557
US

V. Phone/Fax

Practice location:
  • Phone: 970-235-1056
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: WYATT OVERTON
Title or Position: OWNER
Credential: LPC
Phone: 970-301-8755