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General NPI Number Information
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NPI Number | 1508275314
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Entity Type | Organization
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Legal Business Name | A CONSCIOUS PATH COUNSELING, LLC
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Dates
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Enumeration Date | 08/06/2014
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Last Update Date | 08/06/2014
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Provider Practice Location Address
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Address Line | 503 REMINGTON ST STE. 8
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City | FORT COLLINS
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State | CO
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Zip | 80524-3074
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Country | US
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Telephone | 970-222-8586
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Fax | 970-237-6944
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Provider Business Mailing Address
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Address Line | 503 REMINGTON ST STE. 8
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City | FORT COLLINS
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State | CO
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Zip | 80524-3074
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Country | US
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Telephone | 970-222-8586
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Fax | 970-237-6944
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Authorized Official
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Title or Position | OWNER/ THERAPIST
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Name | MS. ABBY L PETERFESO
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Credential | LPC
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Telephone | 970-222-8586
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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 | CSW.09923473
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License Number State | CO
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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 | LPC.0006045
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License Number State | CO
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