Provider Demographics
NPI:1376917369
Name:PELO, JENNIFER (LPC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:PELO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 N SHERMAN ST
Mailing Address - Street 2:#108
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-3520
Mailing Address - Country:US
Mailing Address - Phone:303-505-5262
Mailing Address - Fax:
Practice Address - Street 1:740 N SHERMAN ST
Practice Address - Street 2:#108
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-3520
Practice Address - Country:US
Practice Address - Phone:303-505-5262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-14
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCDE SPEC SRVS 5313101YS0200X
COLPC.0012333101YM0800X, 101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional