MEDICARE: KATIE RENEE NEWTON LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1124674940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIE RENEE NEWTON LPC

Provider Business Mailing Address
First Line	:	264 CAMINO DEL MUNDO
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-8962
Country	:	US
Telephone Number	:	970-232-5224
Fax Number	:	970-341-2074

Provider Business Practice Location Address
First Line	:	2120 MILESTONE DR STE 103
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-5761
Country	:	US
Telephone Number	:	970-829-8780
Fax Number	:	970-341-2074

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2019
Last Update Date	:	10/28/2022

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