Provider Demographics
NPI:1598452286
Name:IVERSON, JENNIE (LPC)
Entity Type:Individual
Prefix:
First Name:JENNIE
Middle Name:
Last Name:IVERSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8756 W INDORE DR
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-4242
Mailing Address - Country:US
Mailing Address - Phone:720-422-4857
Mailing Address - Fax:
Practice Address - Street 1:8756 W INDORE DR
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80128-4242
Practice Address - Country:US
Practice Address - Phone:720-422-4857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-21
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0014810101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional