Provider Demographics
NPI:1427392596
Name:BANKS, JENNIFER MARIE (LPC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MARIE
Last Name:BANKS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:MARIE
Other - Last Name:BANKS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PPC
Mailing Address - Street 1:398 PIN OAK DR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-2369
Mailing Address - Country:US
Mailing Address - Phone:307-760-0422
Mailing Address - Fax:
Practice Address - Street 1:398 PIN OAK DR
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-2369
Practice Address - Country:US
Practice Address - Phone:307-760-0422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2023-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0018115101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional