MEDICARE: HEALTH SERVICES DISTRICT OF NORTHERN LARIMER COUNTY

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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1336858216
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH SERVICES DISTRICT OF NORTHERN LARIMER COUNTY

Provider Business Mailing Address
First Line	:	120 BRISTLECONE DR
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-2031
Country	:	US
Telephone Number	:	970-224-5209
Fax Number	:	970-472-1056

Provider Business Practice Location Address
First Line	:	425 W MULBERRY ST
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80521-2864
Country	:	US
Telephone Number	:	970-224-5209
Fax Number	:

Authorized Official
Title or Position	:	DEPUTY DIRECTOR
Name	:	A LORRAINE HAYWOOD
Credential	:
Telephone Number	:	970-224-5209

Provider Enumeration Date	:	11/18/2022
Last Update Date	:	11/18/2022

Similar Medicare Providers

1821092495 — HEALTH SERVICES DISTRICT OF NORTHERN LARIMER COUNTY
Practice Location Address:

425 W MULBERRY ST
FORT COLLINS, CO
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1487080230 — HEATHER TRUSCHEL
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1043629660 — DR. LESLIE DWYER PSY.D.
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1003267121 — MRS. KAYLA ELIZABETH POULSON MA, LPC
Practice Location Address:

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1295259950 — VICTORIA SPENSER-NICHOLAS GREY LCSW
Practice Location Address:

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1952049017 — KATHERINE PETERS LCSW
Practice Location Address:

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