Provider Demographics
NPI:1427374792
Name:COFFEY, JENNIFER KENNEDY (LMFT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KENNEDY
Last Name:COFFEY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6055 LEHMAN DR STE 102
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-5486
Mailing Address - Country:US
Mailing Address - Phone:804-317-8767
Mailing Address - Fax:
Practice Address - Street 1:6055 LEHMAN DR STE 102
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-5486
Practice Address - Country:US
Practice Address - Phone:804-317-8767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-12
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0001367106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty