Active NPI
Allen Davis III
- Professional Counselor
- Fort Collins, CO
National Provider Identifier
1083227367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC.0019957
- Practice address
- 4856 Innovation Dr
Fort Collins, CO 80525-5539 - Phone
- (970) 494-4200
- Fax
- (970) 613-4475
- NPI assigned
- Aug 26, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | ACD.0002194 | CO | |
| Professional Counselor | 101YP2500X | LPC.0019957 | CO | Primary |
Addresses
Primary practice location
4856 Innovation Dr
Fort Collins, CO 80525-5539
Mailing address
4856 Innovation Dr
Fort Collins, CO 80525-5539
Phone (970) 494-4200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ACD.0002194 | CO | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721606400000",
"number": "1083227367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4856 INNOVATION DR",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805255539",
"telephone_number": "970-494-4200",
"fax_number": "970-613-4475"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4856 INNOVATION DR",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805255539",
"telephone_number": "970-494-4200",
"fax_number": "970-613-4475"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "ALLEN",
"name_suffix": "III",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-26",
"last_updated": "2024-07-22",
"certification_date": "2024-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CO",
"license": "ACD.0002194",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CO",
"license": "LPC.0019957",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.