Provider Demographics
NPI:1336823830
Name:HABURCHAK, JULIANE HONEYWELL
Entity type:Individual
Prefix:MS
First Name:JULIANE
Middle Name:HONEYWELL
Last Name:HABURCHAK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4495 HALE PKWY STE 120
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-6203
Mailing Address - Country:US
Mailing Address - Phone:303-877-9308
Mailing Address - Fax:
Practice Address - Street 1:4495 HALE PKWY STE 120
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-6203
Practice Address - Country:US
Practice Address - Phone:303-877-9308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9895561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO989556OtherSTATE LICENSING BOARD DORA