Provider Demographics
NPI:1417371527
Name:KNIGHT-BAUGHMAN, DARREN (MDIV, MED, LPC)
Entity Type:Individual
Prefix:
First Name:DARREN
Middle Name:
Last Name:KNIGHT-BAUGHMAN
Suffix:
Gender:M
Credentials:MDIV, MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:736 WHALERS WAY STE G200
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-7580
Mailing Address - Country:US
Mailing Address - Phone:970-893-2131
Mailing Address - Fax:
Practice Address - Street 1:736 WHALERS WAY STE G200
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-7580
Practice Address - Country:US
Practice Address - Phone:970-893-2131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-10
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0011816101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health