Provider Demographics
NPI:1558768747
Name:ALLEN, JEREMY ROBERT (LPC)
Entity Type:Individual
Prefix:MR
First Name:JEREMY
Middle Name:ROBERT
Last Name:ALLEN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5181 WARD RD
Mailing Address - Street 2:STE 206
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-1925
Mailing Address - Country:US
Mailing Address - Phone:720-724-6813
Mailing Address - Fax:720-828-6114
Practice Address - Street 1:5181 WARD RD UNIT 206
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-1925
Practice Address - Country:US
Practice Address - Phone:720-204-8510
Practice Address - Fax:303-828-6114
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-03
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC15069101YM0800X
WAWA61181852101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health