Provider Demographics
NPI:1750952289
Name:HOUGHTON, DIANA MARIA (LPC0019337)
Entity type:Individual
Prefix:MS
First Name:DIANA
Middle Name:MARIA
Last Name:HOUGHTON
Suffix:
Gender:F
Credentials:LPC0019337
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5132 CINQUEFOIL LN
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-4425
Mailing Address - Country:US
Mailing Address - Phone:214-868-2910
Mailing Address - Fax:
Practice Address - Street 1:1006 ROBERTSON ST STE A
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3900
Practice Address - Country:US
Practice Address - Phone:970-818-8537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-06
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONLC.0110921101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health