Provider Demographics
NPI:1861013484
Name:DURAN, JENNIFER (AA, BS, MA, LAC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:DURAN
Suffix:
Gender:F
Credentials:AA, BS, MA, LAC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:MORLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4745 DOVER ST
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-3129
Mailing Address - Country:US
Mailing Address - Phone:720-589-6411
Mailing Address - Fax:
Practice Address - Street 1:5650 GREENWOOD PLAZA BLVD STE 144&145
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2307
Practice Address - Country:US
Practice Address - Phone:303-353-9226
Practice Address - Fax:720-923-2321
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-05
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0000686101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)