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NPI Code Detail

MEDICARE: SAMANTHA MCNULTY LPC

MEDICARE: SAMANTHA MCNULTY 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
1101Y00000XCounselor
2101YM0800XMental Health CounselorLPC.0016667CO
3101YP2500XProfessional CounselorLPC.0016667CO

General Provider Information

NPI Number : 1972095057
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA MCNULTY LPC
Provider Business Mailing Address
First Line : 4803 INNOVATION DR STE 3A
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-7308
Country : US
Telephone Number : 970-310-3406
Fax Number :
Provider Business Practice Location Address
First Line : 4803 INNOVATION DR STE 3A
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-7308
Country : US
Telephone Number : 303-995-1237
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2018
Last Update Date : 02/12/2025

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Directions to “ SAMANTHA MCNULTY LPC” Practice Location

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