Provider Demographics
NPI:1053407676
Name:WALTON, ANN ELIZABETH (LCSW, LAC)
Entity type:Individual
Prefix:MS
First Name:ANN
Middle Name:ELIZABETH
Last Name:WALTON
Suffix:
Gender:F
Credentials:LCSW, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 W. DRAKE ROAD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:FT. COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-2865
Mailing Address - Country:US
Mailing Address - Phone:970-222-0215
Mailing Address - Fax:970-472-0787
Practice Address - Street 1:323 W. DRAKE ROAD
Practice Address - Street 2:SUITE 220
Practice Address - City:FT. COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-2865
Practice Address - Country:US
Practice Address - Phone:970-222-0215
Practice Address - Fax:970-472-0787
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO70101YA0400X
CO9925061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO650580OtherANTHEM
CO650580OtherANTHEM