Provider Demographics
NPI:1407320294
Name:MONKS, JENNIFER JAYE
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JAYE
Last Name:MONKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:J
Other - Last Name:KENDALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1608 SUMMERNIGHT TER
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-2730
Mailing Address - Country:US
Mailing Address - Phone:719-761-5972
Mailing Address - Fax:
Practice Address - Street 1:1608 SUMMERNIGHT TER
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-2730
Practice Address - Country:US
Practice Address - Phone:719-266-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-15
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
COLPCC.0017577101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician