Provider Demographics
NPI:1619966678
Name:BOGUSHEFSKY, KATHERINE DIANE (MC, LPC)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:DIANE
Last Name:BOGUSHEFSKY
Suffix:
Gender:F
Credentials:MC, LPC
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:DIANE
Other - Last Name:KUHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16515 S 40TH ST STE 139
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-0560
Mailing Address - Country:US
Mailing Address - Phone:480-205-4040
Mailing Address - Fax:480-785-1647
Practice Address - Street 1:16515 S 40TH ST
Practice Address - Street 2:#139
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-0558
Practice Address - Country:US
Practice Address - Phone:480-205-4040
Practice Address - Fax:480-785-1647
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-10681101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional