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General NPI Number Information
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NPI Number | 1003672387
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Entity Type | Organization
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Legal Business Name | ALCHEMY COUNSELING, CONSULTATION, AND WELLNESS
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Dates
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Enumeration Date | 02/26/2024
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | 215 MATHEWS ST STE 300
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City | FORT COLLINS
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State | CO
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Zip | 80524-3451
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Country | US
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Telephone | 970-217-7796
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Fax |
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Provider Business Mailing Address
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Address Line | 2444 CROWN VIEW DR
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City | FORT COLLINS
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State | CO
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Zip | 80526-5821
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Country | US
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Telephone | 970-217-7796
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ASHLEY SHAW
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Credential | LPC
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Telephone | 970-217-7796
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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