Provider Demographics
NPI:1376661132
Name:COUGET, ANDRE PAUL (LCSW)
Entity type:Individual
Prefix:MR
First Name:ANDRE
Middle Name:PAUL
Last Name:COUGET
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2629 REDWING RD
Mailing Address - Street 2:SUITE 295
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-6315
Mailing Address - Country:US
Mailing Address - Phone:970-402-0170
Mailing Address - Fax:970-282-0015
Practice Address - Street 1:2629 REDWING RD
Practice Address - Street 2:SUITE 295
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-6315
Practice Address - Country:US
Practice Address - Phone:970-402-0170
Practice Address - Fax:970-282-0015
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9892281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical