Provider Demographics
NPI:1487279972
Name:FUJITA MAUS, REINA (MA, LPCC)
Entity type:Individual
Prefix:
First Name:REINA
Middle Name:
Last Name:FUJITA MAUS
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3775 IRIS AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-2043
Mailing Address - Country:US
Mailing Address - Phone:773-943-0678
Mailing Address - Fax:
Practice Address - Street 1:3775 IRIS AVE STE 6
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-2043
Practice Address - Country:US
Practice Address - Phone:773-943-0678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-10
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0015979101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health