Provider Demographics
NPI:1679643977
Name:FORNEY, NANCY MARIE (LPC)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:MARIE
Last Name:FORNEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8242 BURL WOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80908-1485
Mailing Address - Country:US
Mailing Address - Phone:719-301-0290
Mailing Address - Fax:719-426-9776
Practice Address - Street 1:3230 E WOODMEN RD STE 110B
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-8502
Practice Address - Country:US
Practice Address - Phone:719-301-0290
Practice Address - Fax:719-426-9776
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2021-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC11903101YM0800X
CO0015269101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZLPC11903OtherTHERAPIST
CO0015269OtherTHERAPIST