Provider Demographics
NPI:1487834347
Name:REDDY, SUJATHA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:SUJATHA
Middle Name:
Last Name:REDDY
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 1:1019 S ALKIRE ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-3111
Mailing Address - Country:US
Mailing Address - Phone:303-325-5617
Mailing Address - Fax:720-368-5157
Practice Address - Street 1:7596 W JEWELL AVE STE 303
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80232-6839
Practice Address - Country:US
Practice Address - Phone:303-325-5617
Practice Address - Fax:720-368-5157
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-08
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC0012340101Y00000X, 101YP1600X, 101YS0200X, 102L00000X, 132700000X, 133N00000X, 133NN1002X, 171400000X, 172V00000X, 174H00000X, 374K00000X, 405300000X, 101YM0800X
OHC.0600087101YP2500X
COLPC.0012340101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No132700000XDietary & Nutritional Service ProvidersDietary Manager
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No171400000XOther Service ProvidersHealth & Wellness Coach
No172V00000XOther Service ProvidersCommunity Health Worker
No174H00000XOther Service ProvidersHealth Educator
No374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner
No405300000XOther Service ProvidersPrevention Professional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO09070508Medicaid