Provider Demographics
NPI:1295357176
Name:GERSHEN, JENNA ROSE (PSYD)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:ROSE
Last Name:GERSHEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 S STEELE ST STE 950
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-2843
Mailing Address - Country:US
Mailing Address - Phone:720-772-6915
Mailing Address - Fax:
Practice Address - Street 1:50 S STEELE ST STE 950
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-2843
Practice Address - Country:US
Practice Address - Phone:720-772-6915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-13
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0005716103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical