Healthcare Provider Details

I. General information

NPI: 1700326881
Provider Name (Legal Business Name): YAKITTA RENFROE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2017
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3210 E WOODMEN RD STE 110
COLORADO SPRINGS CO
80920-3591
US

IV. Provider business mailing address

3210 E WOODMEN RD STE 100
COLORADO SPRINGS CO
80920-3591
US

V. Phone/Fax

Practice location:
  • Phone: 609-442-9722
  • Fax: 719-960-3286
Mailing address:
  • Phone: 609-442-9722
  • Fax: 719-960-3286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0013563
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: