Provider Demographics
NPI:1093072506
Name:FORBES, JENNIFER (MA, LPC, LCPC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:FORBES
Suffix:
Gender:F
Credentials:MA, LPC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2708 TOBACCO RD APT B
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66503-8916
Mailing Address - Country:US
Mailing Address - Phone:303-912-5865
Mailing Address - Fax:
Practice Address - Street 1:2708 TOBACCO RD
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66503-8915
Practice Address - Country:US
Practice Address - Phone:720-515-9186
Practice Address - Fax:844-685-9507
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2606101YM0800X
CO0012583101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty