Provider Demographics
NPI:1912648817
Name:BIGBOY, STEFAN JAMES (LPC)
Entity Type:Individual
Prefix:MR
First Name:STEFAN
Middle Name:JAMES
Last Name:BIGBOY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5123 WILLIAMS FORK TRL APT 102
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-3446
Mailing Address - Country:US
Mailing Address - Phone:720-364-6333
Mailing Address - Fax:
Practice Address - Street 1:5123 WILLIAMS FORK TRL APT 102
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-3446
Practice Address - Country:US
Practice Address - Phone:720-364-6333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0018124101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health