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Individual

MR. ROGER A COUGHLAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
760 WHALERS WAY, C-200, FT COLLINS, CO 80525-3370
(970) 495-4851
(970) 204-7883
Mailing address
760 WHALERS WAY, C-200, FT COLLINS, CO 80525-3370
(970) 495-4851
(970) 204-7883

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
986008
CO
106H00000X
Marriage & Family Therapist
Primary
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
986008
LICENSED SOCIAL WORKER
CO
Enumeration date
09/06/2005
Last updated
09/11/2025
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