Provider Demographics
NPI:1821571423
Name:PHIPPEN, JENNIFER (LCSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:PHIPPEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1540 MAIN STREET
Mailing Address - Street 2:SUITE 218 #211
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-7914
Mailing Address - Country:US
Mailing Address - Phone:970-239-3553
Mailing Address - Fax:970-449-0573
Practice Address - Street 1:706 S COLLEGE AVE STE 207F
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-9860
Practice Address - Country:US
Practice Address - Phone:970-239-3553
Practice Address - Fax:970-449-0573
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099254251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical