Provider Demographics
NPI:1134489552
Name:HARBUZ, JILLIAN MARIE (MA, LPC)
Entity type:Individual
Prefix:MS
First Name:JILLIAN
Middle Name:MARIE
Last Name:HARBUZ
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 733
Mailing Address - Street 2:
Mailing Address - City:INDIAN HILLS
Mailing Address - State:CO
Mailing Address - Zip Code:80454-0733
Mailing Address - Country:US
Mailing Address - Phone:720-431-3365
Mailing Address - Fax:
Practice Address - Street 1:30792 SOUTHVIEW DR STE 207
Practice Address - Street 2:
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-7986
Practice Address - Country:US
Practice Address - Phone:720-431-3365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-18
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0014403101YM0800X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist