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NPI Code Detail

MEDICARE: EDGAR H. FERNANDEZ

MEDICARE:   EDGAR H. FERNANDEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2101YP2500XProfessional CounselorLPC.0012724CO

General Provider Information

NPI Number : 1326346362
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDGAR H. FERNANDEZ
Provider Business Mailing Address
First Line : 1440 GROVE ST UNIT A
Second Line :
City : DENVER
State : CO
Zip : 80204-2201
Country : US
Telephone Number : 303-504-1560
Fax Number :
Provider Business Practice Location Address
First Line : 1440 GROVE ST UNIT A
Second Line :
City : DENVER
State : CO
Zip : 80204-2201
Country : US
Telephone Number : 720-254-1562
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2011
Last Update Date : 12/21/2023

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Directions to “ EDGAR H. FERNANDEZ ” Practice Location

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