Provider Demographics
NPI:1073005104
Name:KIBURI, DENISE (LPC)
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:
Last Name:KIBURI
Suffix:
Gender:F
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:JEWISH FAMILY AND CHILDREN SERVICES
Mailing Address - Street 2:880 N COLORADO STREET
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233
Mailing Address - Country:US
Mailing Address - Phone:314-249-6682
Mailing Address - Fax:
Practice Address - Street 1:JEWISH FAMILY AND CHILDREN SERVICES
Practice Address - Street 2:880 N COLORADO STREET
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233
Practice Address - Country:US
Practice Address - Phone:314-249-6682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-04
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-19848101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty