=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053407676
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANN ELIZABETH WALTON LCSW, LAC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/04/2006
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 323 W. DRAKE ROAD SUITE 220
-----------------------------------------------------
City | FT. COLLINS
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80526-2865
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-222-0215
-----------------------------------------------------
Fax | 970-472-0787
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 323 W. DRAKE ROAD SUITE 220
-----------------------------------------------------
City | FT. COLLINS
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80526-2865
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-222-0215
-----------------------------------------------------
Fax | 970-472-0787
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number | 70
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 992506
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------