Provider Demographics
NPI:1205554052
Name:BARAJAS, MARY KATHERINE (LPC, NCC)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:KATHERINE
Last Name:BARAJAS
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:BARAJAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3131 W 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-2203
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3131 W 14TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-2203
Practice Address - Country:US
Practice Address - Phone:303-953-5943
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-18
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0018399101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional