Provider Demographics
NPI:1336731223
Name:BLUEFORD, JILLIAN (PHD, LPC, NCC, CT)
Entity Type:Individual
Prefix:DR
First Name:JILLIAN
Middle Name:
Last Name:BLUEFORD
Suffix:
Gender:F
Credentials:PHD, LPC, NCC, CT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 NELSON ST APT 506
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-4589
Mailing Address - Country:US
Mailing Address - Phone:407-421-1780
Mailing Address - Fax:
Practice Address - Street 1:6906 SOUTH HOLLY CIRCLE
Practice Address - Street 2:SUITE 304
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112
Practice Address - Country:US
Practice Address - Phone:970-528-0634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0016833101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health