Healthcare Provider Details

I. General information

NPI: 1144672122
Provider Name (Legal Business Name): THOMAS EUGENE MUNHOLLAND LAC, MAC, LPCC, CRC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2016
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 N WILSON AVE
LOVELAND CO
80537-4461
US

IV. Provider business mailing address

4856 INNOVATION DR
FORT COLLINS CO
80525-5539
US

V. Phone/Fax

Practice location:
  • Phone: 970-494-4200
  • Fax:
Mailing address:
  • Phone: 970-494-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberACD.0002056
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0021361
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: