Provider Demographics
NPI:1104028653
Name:RENSHAW-FRITZLER, JEAN E (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:E
Last Name:RENSHAW-FRITZLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:JEAN
Other - Middle Name:E
Other - Last Name:RENSHAW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:109 E. RAILROAD AVENUE
Mailing Address - Street 2:
Mailing Address - City:FT. MORGAN
Mailing Address - State:CO
Mailing Address - Zip Code:80701-3810
Mailing Address - Country:US
Mailing Address - Phone:970-867-6900
Mailing Address - Fax:970-867-6900
Practice Address - Street 1:109 E. RAILROAD AVENUE
Practice Address - Street 2:SUITE 200
Practice Address - City:FT. MORGAN
Practice Address - State:CO
Practice Address - Zip Code:80701-3810
Practice Address - Country:US
Practice Address - Phone:970-867-6900
Practice Address - Fax:970-867-6900
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO101YP2500X
859101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional