Healthcare Provider Details

I. General information

NPI: 1124674940
Provider Name (Legal Business Name): KATIE RENEE NEWTON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2019
Last Update Date: 10/28/2022
Certification Date: 10/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 MILESTONE DR STE 103
FORT COLLINS CO
80525-5761
US

IV. Provider business mailing address

264 CAMINO DEL MUNDO
FORT COLLINS CO
80524-8962
US

V. Phone/Fax

Practice location:
  • Phone: 970-829-8780
  • Fax: 970-341-2074
Mailing address:
  • Phone: 970-232-5224
  • Fax: 970-341-2074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: