Provider Demographics
NPI:1134117864
Name:BUJAK PHILLIPS, KATHERINE ROSE (LPC)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:ROSE
Last Name:BUJAK PHILLIPS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5892 S PIERSON ST
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-1957
Mailing Address - Country:US
Mailing Address - Phone:303-504-1082
Mailing Address - Fax:
Practice Address - Street 1:1733 VINE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-1119
Practice Address - Country:US
Practice Address - Phone:303-504-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CO3557101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health