Provider Demographics
NPI:1639233299
Name:FYFE, WILLIAM J (ED D)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:FYFE
Suffix:
Gender:M
Credentials:ED D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 KIPLING ST
Mailing Address - Street 2:SUITE 306
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-8002
Mailing Address - Country:US
Mailing Address - Phone:303-232-6972
Mailing Address - Fax:303-232-1473
Practice Address - Street 1:710 KIPLING ST
Practice Address - Street 2:SUITE 306
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-8002
Practice Address - Country:US
Practice Address - Phone:303-232-6972
Practice Address - Fax:303-232-1473
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO782103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling