Provider Demographics
NPI:1033607346
Name:ROSENFELD, JENNA TARYN (LCSW)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:TARYN
Last Name:ROSENFELD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10888 BROOKLAWN RD
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80130-6628
Mailing Address - Country:US
Mailing Address - Phone:954-881-0999
Mailing Address - Fax:
Practice Address - Street 1:10888 BROOKLAWN RD
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80130-6628
Practice Address - Country:US
Practice Address - Phone:954-881-0999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-23
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099250111041C0700X
FLSW146231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical