Provider Demographics
NPI:1992296883
Name:HAYGOOD, AMANDA (LPC, LMFTC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:HAYGOOD
Suffix:
Gender:F
Credentials:LPC, LMFTC
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:COLANGELO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:813 LAPORTE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80521-2520
Mailing Address - Country:US
Mailing Address - Phone:720-563-9315
Mailing Address - Fax:
Practice Address - Street 1:417 S HOWES ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80521-2801
Practice Address - Country:US
Practice Address - Phone:720-563-9315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-25
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0013753101YP2500X
COMFTC.0013513106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional