Individual provider Active NPI

Yuko Kishimoto, PH.D.

  • Counseling Psychologist
  • Denver, CO
National Provider Identifier
1487825246
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
4530 Issued in CO
Practice address
4495 Hale Pkwy Ste 116
Denver, CO 80220-6203
Phone
(303) 564-4830
NPI assigned
Mar 19, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 33457 TX
Counseling Psychologist 103TC1900X 4030 NC
Counseling Psychologist 103TC1900X 4530 CO Primary

Addresses

Primary practice location

4495 Hale Pkwy Ste 116
Denver, CO 80220-6203

Mailing address

903 Uinta Way
Denver, CO 80230-6885
Phone (303) 564-4830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
4530COMDMental Health Counselor
33457TXMDCounseling Psychologist
4030NCMDChemical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Career Fulfillment Services, PLLC Counseling CurrentSince Sep 21, 2011 Accepting new patients
Origins Psychological Services, LLC Counseling Current Accepting new patients

Locations

401 W 1st St
Ste G
Greenville, NC 27834
Phone (252) 412-7022

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1487825246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 UINTA WAY",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802306885",
            "telephone_number": "303-564-4830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4495 HALE PKWY STE 116",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802206203",
            "telephone_number": "303-564-4830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISHIMOTO",
        "first_name": "YUKO",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-19",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "TX",
            "license": "33457",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NC",
            "license": "4030",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CO",
            "license": "4530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.