KEITH BLACKBURN - NPI 1871222810 - Counselor in Fort Collins, CO

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101Y00000X.

On this page

About Keith Blackburn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEITH BLACKBURN (NPI 1871222810) is an individual counselor in Fort Collins, Colorado and active in the NPI registry since June 2022.

NPPES Registry Identity

NPI1871222810

Entity TypeIndividualMale

Primary Taxonomy101Y00000X

Provider Legal NameKEITH BLACKBURN

Location Address4856 INNOVATION DRFort Collins, CO 80525-5539

Mailing Address4856 Innovation DrFort Collins, CO 80525-5539 · (970) 494-4200 · Fax (844) 270-1824

Phone(970) 494-4200

Fax(844) 270-1824

Sole ProprietorNo

Enumeration DateJune 6, 2022

Last NPPES UpdateMarch 19, 20252 updates tracked since enumeration

NPPES CertifiedMarch 19, 2025

✔ NPI 1871222810 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers

Taxonomy Code101Y00000X

Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Also ListedDriverTaxonomy 172A00000X

4856 INNOVATION DR, Fort Collins, CO 80525

Open in Google Maps ↗