Healthcare Provider Details
I. General information
NPI: 1912259326
Provider Name (Legal Business Name): LINDSEY L PHILLIPS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/09/2012
Last Update Date: 10/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1250 N WILSON AVE
LOVELAND CO
80537-4461
US
IV. Provider business mailing address
125 CRESTRIDGE ST
FORT COLLINS CO
80525-3934
US
V. Phone/Fax
- Phone: 970-494-9870
- Fax: 970-346-9800
- Phone: 970-494-9761
- Fax: 970-346-9800
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | LPC-6480 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: