Provider Demographics
NPI:1568246825
Name:KIRK, JENNIFER JACOBSON (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:JACOBSON
Last Name:KIRK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1068 S 88TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-9459
Mailing Address - Country:US
Mailing Address - Phone:303-915-0108
Mailing Address - Fax:720-627-5843
Practice Address - Street 1:1068 S 88TH ST STE A
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-9459
Practice Address - Country:US
Practice Address - Phone:303-915-0108
Practice Address - Fax:720-627-5843
Is Sole Proprietor?:No
Enumeration Date:2023-08-18
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2899103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation