Provider Demographics
NPI:1114353984
Name:BOSLEY, WHITNEY (LPC, LAC)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:BOSLEY
Suffix:
Gender:F
Credentials:LPC, LAC
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:
Other - Last Name:HOLCOMB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, LAC
Mailing Address - Street 1:4115 BOARDWALK DR UNIT 100
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-5945
Mailing Address - Country:US
Mailing Address - Phone:970-493-4580
Mailing Address - Fax:970-797-2859
Practice Address - Street 1:4115 BOARDWALK DR UNIT 100
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-5945
Practice Address - Country:US
Practice Address - Phone:970-493-4580
Practice Address - Fax:970-797-2859
Is Sole Proprietor?:No
Enumeration Date:2013-09-24
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0012299101YP2500X
COACD.0000443101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)