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NPI Code Detail

MEDICARE: JOY RYAN FANGMAN NCC, LPC

MEDICARE: JOY RYAN FANGMAN NCC, 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
1101YM0800XMental Health CounselorLPC.0018009CO
2101YP2500XProfessional CounselorLPC.0018009CO

General Provider Information

NPI Number : 1770049942
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOY RYAN FANGMAN NCC, LPC
Provider Business Mailing Address
First Line : 7114 W JEFFERSON AVE STE 306
Second Line :
City : LAKEWOOD
State : CO
Zip : 80235-2373
Country : US
Telephone Number : 720-581-8759
Fax Number :
Provider Business Practice Location Address
First Line : 7114 W JEFFERSON AVE STE 306
Second Line :
City : LAKEWOOD
State : CO
Zip : 80235-2373
Country : US
Telephone Number : 970-310-3406
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2019
Last Update Date : 03/13/2026

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