Provider Demographics
NPI:1942432802
Name:JAEGER, CHARIS (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:CHARIS
Middle Name:
Last Name:JAEGER
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29893 LEE RD
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-7245
Mailing Address - Country:US
Mailing Address - Phone:860-550-2414
Mailing Address - Fax:
Practice Address - Street 1:29893 LEE RD
Practice Address - Street 2:
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-7245
Practice Address - Country:US
Practice Address - Phone:860-550-2414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-11
Last Update Date:2021-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.00002120101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health