Provider Demographics
NPI:1952629438
Name:FEENIXWEST COUNSELING, LLC
Entity Type:Organization
Organization Name:FEENIXWEST COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCE
Authorized Official - Middle Name:FERGUSON
Authorized Official - Last Name:HOROWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:970-231-3721
Mailing Address - Street 1:2006 WESTVIEW ROAD
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:85024-1853
Mailing Address - Country:US
Mailing Address - Phone:970-231-3721
Mailing Address - Fax:970-224-4335
Practice Address - Street 1:19 OLD TOWN SQ
Practice Address - Street 2:MAILBOX 238
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-2471
Practice Address - Country:US
Practice Address - Phone:970-231-3721
Practice Address - Fax:970-224-4335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-10
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COB5104Medicare PIN