Provider Demographics
NPI:1659719870
Name:JADE, JAMI J (LCSW)
Entity Type:Individual
Prefix:
First Name:JAMI
Middle Name:J
Last Name:JADE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JAMI
Other - Middle Name:
Other - Last Name:BAMAT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1920 ADRIEL CT
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-2207
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11236 HILLCREST DR
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-9392
Practice Address - Country:US
Practice Address - Phone:970-460-6886
Practice Address - Fax:970-638-3268
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011028232104100000X
MO20140086921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker