Provider Demographics
NPI:1184029373
Name:BOGAN, JENNA (MA)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:BOGAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1870 W 122ND AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-2024
Mailing Address - Country:US
Mailing Address - Phone:303-853-3500
Mailing Address - Fax:303-853-3754
Practice Address - Street 1:8931 HURON ST.
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80260
Practice Address - Country:US
Practice Address - Phone:303-853-3588
Practice Address - Fax:303-853-3754
Is Sole Proprietor?:No
Enumeration Date:2014-10-30
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health