Provider Demographics
NPI:1780710384
Name:YONEYAMA-SIMS, KEIKO (LMFT)
Entity type:Individual
Prefix:
First Name:KEIKO
Middle Name:
Last Name:YONEYAMA-SIMS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9163
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-0163
Mailing Address - Country:US
Mailing Address - Phone:720-739-0668
Mailing Address - Fax:
Practice Address - Street 1:1805 S BELLAIRE ST STE 465-03
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4305
Practice Address - Country:US
Practice Address - Phone:720-739-0668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50191106H00000X
106H00000X
CO0001179106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO50725033Medicaid