Provider Demographics
NPI:1821625245
Name:BARTSCH, JENNA LEIGH
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:LEIGH
Last Name:BARTSCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1527 COLE BLVD STE 275
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80401-3423
Mailing Address - Country:US
Mailing Address - Phone:720-706-9685
Mailing Address - Fax:
Practice Address - Street 1:1527 COLE BLVD STE 275
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80401-3423
Practice Address - Country:US
Practice Address - Phone:720-706-9685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-25
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL222Q00000X
COLSW.0009925358104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist