Provider Demographics
NPI:1457416547
Name:JIMENEZ, YUMIL JOSEFINA (MED, LPC, CAC III)
Entity type:Individual
Prefix:
First Name:YUMIL
Middle Name:JOSEFINA
Last Name:JIMENEZ
Suffix:
Gender:F
Credentials:MED, LPC, CAC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1518 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-1521
Mailing Address - Country:US
Mailing Address - Phone:303-593-2751
Mailing Address - Fax:
Practice Address - Street 1:1518 MAIN ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-1521
Practice Address - Country:US
Practice Address - Phone:303-593-2751
Practice Address - Fax:303-284-4393
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6613101YA0400X
CO4846101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)