Provider Demographics
NPI:1477853471
Name:FUENMAYOR, YENNI C (LCSW)
Entity Type:Individual
Prefix:
First Name:YENNI
Middle Name:C
Last Name:FUENMAYOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 E 16TH AVE
Mailing Address - Street 2:BOX #4
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-5195
Mailing Address - Country:US
Mailing Address - Phone:303-297-4020
Mailing Address - Fax:303-764-6271
Practice Address - Street 1:11059 E BETHANY DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2622
Practice Address - Country:US
Practice Address - Phone:303-617-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7221101YA0400X
CO099251591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)