Provider Demographics
NPI:1588192108
Name:HASSELL, JENNIFER LEANN (MSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LEANN
Last Name:HASSELL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1060 CENTENNIAL DR
Mailing Address - Street 2:
Mailing Address - City:BENNETT
Mailing Address - State:CO
Mailing Address - Zip Code:80102-7874
Mailing Address - Country:US
Mailing Address - Phone:303-710-4160
Mailing Address - Fax:
Practice Address - Street 1:1060 CENTENNIAL DR
Practice Address - Street 2:
Practice Address - City:BENNETT
Practice Address - State:CO
Practice Address - Zip Code:80102-7874
Practice Address - Country:US
Practice Address - Phone:228-297-6493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-25
Last Update Date:2024-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099277971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty