Colette A Bukowski, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E4173 Issued in OH

Practice address

34900 Chardon Rd
Suite 102
Willoughby, OH 44094-9161

Phone

(216) 548-1439

NPI assigned

Jan 18, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185408000000",
    "number": "1598818312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 SUNVIEW RD",
            "city": "LYNDHURST",
            "state": "OH",
            "postal_code": "441242843",
            "telephone_number": "440-473-0230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34900 CHARDON RD",
            "address_2": "SUITE 102",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440949161",
            "telephone_number": "216-548-1439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUKOWSKI",
        "first_name": "COLETTE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E4173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Willoughby, OH
• Providers in Willoughby, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.