Provider Demographics
NPI:1861079717
Name:BOURNIA, LYNN (LPC)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:BOURNIA
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 1:28753 COUNTY ROAD 56
Mailing Address - Street 2:
Mailing Address - City:ILIFF
Mailing Address - State:CO
Mailing Address - Zip Code:80736-9634
Mailing Address - Country:US
Mailing Address - Phone:970-571-0195
Mailing Address - Fax:
Practice Address - Street 1:28753 COUNTY ROAD 56
Practice Address - Street 2:
Practice Address - City:ILIFF
Practice Address - State:CO
Practice Address - Zip Code:80736-9634
Practice Address - Country:US
Practice Address - Phone:970-281-7776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0018047101YM0800X
NE12409101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health