Healthcare Provider Details

I. General information

NPI: 1194649954
Provider Name (Legal Business Name): CASEY BOGUSZ LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13659 E 104TH AVE UNIT 650
COMMERCE CITY CO
80022-9477
US

IV. Provider business mailing address

1303 DELAWARE AVE STE 113
WILMINGTON DE
19806-3406
US

V. Phone/Fax

Practice location:
  • Phone: 986-206-0414
  • Fax:
Mailing address:
  • Phone: 986-206-0414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC.0021556
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: