Provider Demographics
NPI:1528362209
Name:THORSTAD, JENNIFER A (LPC (COLORADO))
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:A
Last Name:THORSTAD
Suffix:
Gender:F
Credentials:LPC (COLORADO)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1754 N LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1117
Mailing Address - Country:US
Mailing Address - Phone:303-989-5534
Mailing Address - Fax:
Practice Address - Street 1:1754 N LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1117
Practice Address - Country:US
Practice Address - Phone:303-989-5534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-10
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8088101YP2500X
COLPC0013309101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional