Healthcare Provider Details

I. General information

NPI: 1962036731
Provider Name (Legal Business Name): CULTIVATING HOPE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2020
Last Update Date: 05/20/2022
Certification Date: 05/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3532 E PROSPECT RD
FORT COLLINS CO
80525-9738
US

IV. Provider business mailing address

3532 E PROSPECT RD
FORT COLLINS CO
80525-9738
US

V. Phone/Fax

Practice location:
  • Phone: 970-829-8568
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ANGELA WHITE
Title or Position: OWNER
Credential:
Phone: 970-829-8568