MEDICARE: WOODSWALK COUNSELING, LLC

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
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1730046814
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOODSWALK COUNSELING, LLC

Provider Business Mailing Address
First Line	:	2850 MCCLELLAND DR STE 3000G
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-5206
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2850 MCCLELLAND DR STE 3000G
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-5206
Country	:	US
Telephone Number	:	720-288-0860
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JEROME MYERSON
Credential	:
Telephone Number	:	720-288-0033

Provider Enumeration Date	:	01/08/2026
Last Update Date	:	01/14/2026

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