Provider Demographics
NPI:1407304330
Name:KEYSER, JENNIFER (CAS, MA, LPC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:KEYSER
Suffix:
Gender:F
Credentials:CAS, MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 S COLLEGE AVE UNIT 202
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-2558
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3000 S COLLEGE AVE UNIT 202
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-2558
Practice Address - Country:US
Practice Address - Phone:970-221-4057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-20
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACC.0998277101YA0400X
101Y00000X, 101YA0400X, 101YM0800X
COACB.8277101YA0400X
COLPC.14001101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health