Provider Demographics
NPI:1235003914
Name:RODRIGUEZ PENILLA, AMAURY (LPC)
Entity type:Individual
Prefix:
First Name:AMAURY
Middle Name:
Last Name:RODRIGUEZ PENILLA
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 W OAK ST STE 108
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-7110
Mailing Address - Country:US
Mailing Address - Phone:970-409-4151
Mailing Address - Fax:
Practice Address - Street 1:149 W OAK ST STE 108
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-7110
Practice Address - Country:US
Practice Address - Phone:970-409-4151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-03
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0022918101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional