Provider Demographics
NPI:1558523662
Name:YANG, BRENDA LEE (RN, MA, LPC)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:LEE
Last Name:YANG
Suffix:
Gender:F
Credentials:RN, MA, LPC
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:LEE
Other - Last Name:RAMER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN, MA, LPC
Mailing Address - Street 1:4410 ARAPHAHOE AVE. #205
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303
Mailing Address - Country:US
Mailing Address - Phone:720-530-9958
Mailing Address - Fax:303-546-0047
Practice Address - Street 1:4410 ARAPHAHOE AVE. #205
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303
Practice Address - Country:US
Practice Address - Phone:720-530-9958
Practice Address - Fax:303-546-0047
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1698101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health