Provider Demographics
NPI:1942710546
Name:BRANNON, JOHN YUMA (MA, MFC, CMIT, LPCC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:YUMA
Last Name:BRANNON
Suffix:
Gender:M
Credentials:MA, MFC, CMIT, LPCC
Other - Prefix:DR
Other - First Name:JOHN
Other - Middle Name:YUMA
Other - Last Name:BRANNON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, MFC, CMIT, LPCC
Mailing Address - Street 1:4720 GALLEY RD STE 101
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80915-2735
Mailing Address - Country:US
Mailing Address - Phone:719-999-5054
Mailing Address - Fax:
Practice Address - Street 1:4720 GALLEY RD STE 101
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80915-2735
Practice Address - Country:US
Practice Address - Phone:719-999-5054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-09
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0015284101YM0800X, 102L00000X, 101YP2500X
CO18183101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst