Provider Demographics
NPI:1033907647
Name:BRAUNECKER, AMY ELYSE (MFT-C)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:ELYSE
Last Name:BRAUNECKER
Suffix:
Gender:
Credentials:MFT-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 BEDIVERE CIR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-1908
Mailing Address - Country:US
Mailing Address - Phone:303-475-3441
Mailing Address - Fax:
Practice Address - Street 1:2575 PARK LN STE 210
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-3200
Practice Address - Country:US
Practice Address - Phone:303-475-3441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMFTC.0014817106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist