Provider Demographics
NPI:1972809853
Name:SUBLETT, KAREN JEAN (CCH)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:JEAN
Last Name:SUBLETT
Suffix:
Gender:F
Credentials:CCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 3RD ST
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-2438
Mailing Address - Country:US
Mailing Address - Phone:303-909-1226
Mailing Address - Fax:720-863-1957
Practice Address - Street 1:34271 COLUMBINE TRL W
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:CO
Practice Address - Zip Code:80107-7838
Practice Address - Country:US
Practice Address - Phone:303-909-1226
Practice Address - Fax:720-863-1957
Is Sole Proprietor?:No
Enumeration Date:2011-02-09
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12235102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst