Timothy Allport, CAC III
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Lafayette, CO
NPI 1104255538 · NPPES record last updated Nov 6, 2013
Key facts
- NPI
- 1104255538
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 3791 (CO)
- Practice address
- 100 East South Boulder Road
Suite 105
Lafayette, CO 80026 - Phone
- (303) 665-7037
- Fax
- (720) 890-7111
- NPI assigned
- Nov 6, 2013
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3791 | CO | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CO | ||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 3791 | CO | Yes |
Addresses
Primary practice location
100 East South Boulder Road
Suite 105
Lafayette, CO 80026
Mailing address
100 East South Boulder Road
Suite 105
Lafayette, CO 80026
Phone (303) 665-7037
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 80776230 | Medicaid | CO |
Other providers in Lafayette, CO
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- Tiffany L Allen
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- Zack G. Alme
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All providers in Lafayette, CO · Addiction (Substance Use Disorder) Counselor in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 6, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.