Healthcare Provider Details

I. General information

NPI: 1407765472
Provider Name (Legal Business Name): AMETHYST LOWE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMY LOWE

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 W DRAKE RD STE 216
FORT COLLINS CO
80526-8120
US

IV. Provider business mailing address

943 SCHLAGEL ST UNIT 5
FORT COLLINS CO
80524-4293
US

V. Phone/Fax

Practice location:
  • Phone: 970-541-9892
  • Fax:
Mailing address:
  • Phone: 970-412-8552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC.0025171
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: