MEDICARE: ROBERT FYFE LPC

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
1	101YM0800X	Mental Health Counselor	2015029909	MO
2	101YM0800X	Mental Health Counselor	LPC.0016875	CO

General Provider Information

NPI Number	:	1396112389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT FYFE LPC

Provider Business Mailing Address
First Line	:	2384 S HOYT ST
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80227-2234
Country	:	US
Telephone Number	:	314-467-0155
Fax Number	:	314-552-7191

Provider Business Practice Location Address
First Line	:	6655 W JEWELL AVE STE 215
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80232-7108
Country	:	US
Telephone Number	:	314-467-0155
Fax Number	:	314-552-7191

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2015
Last Update Date	:	09/27/2022

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