Collette Fisk, LPCC
Individual provider Active NPI Mental Health Counselor · Moffat, CO
NPI 1225929334 · NPPES record last updated Jul 15, 2025
Key facts
- NPI
- 1225929334
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 0023710 (CO)
- Practice address
- 304 Reynolds Ave # 321
Moffat, CO 81143-5033 - Phone
- (719) 465-9111
- NPI assigned
- Jul 15, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 0023710 | CO | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0023710 | CO | Yes |
Addresses
Primary practice location
304 Reynolds Ave # 321
Moffat, CO 81143-5033
Mailing address
PO Box 321
Moffat, CO 81143-0321
Phone (719) 465-9111
Other providers in Moffat, CO
- Amanda C Hawkins
- Annabel H Jepsen
- Life'S Hope Therapeutic Services PLLC
- Ezra Lockhart
- McKeeg Russell
All providers in Moffat, CO · Mental Health 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 Jul 15, 2025. 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.