Individual provider Active NPI

Jennesa Yanez, MS

  • Counselor
  • Broomfield, CO
National Provider Identifier
1780004762
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LPC.0012578 Issued in CO
Practice address
80 Garden Ctr Ste 166
Broomfield, CO 80020-1790
Phone
(303) 877-3710
NPI assigned
Apr 17, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPP.0001311 CO
Counselor 101Y00000X LPC.0012578 CO Primary

Addresses

Primary practice location

80 Garden Ctr Ste 166
Broomfield, CO 80020-1790

Mailing address

80 Garden Ctr Ste 166
Broomfield, CO 80020-1790

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)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LPC.0012578COMDCounselor
LPP.0001311COMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Running Waters Counseling LLC CurrentSince Mar 19, 2023 Accepting new patients

Locations

80 Garden Ctr
Ste 166
Broomfield, CO 80020
Phone (303) 219-0895

Organizations & group practices 1

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": "1397692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1780004762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 GARDEN CTR STE 166",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800201790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 GARDEN CTR STE 166",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800201790",
            "telephone_number": "303-877-3710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANEZ",
        "first_name": "JENNESA",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-17",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPP.0001311",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CO",
            "license": "LPC.0012578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; 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.