Provider Demographics
NPI:1023627361
Name:JENNINGS, ALISON BATTS (LCSW)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:BATTS
Last Name:JENNINGS
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:PO BOX 1519
Mailing Address - Street 2:
Mailing Address - City:LYONS
Mailing Address - State:CO
Mailing Address - Zip Code:80540-1519
Mailing Address - Country:US
Mailing Address - Phone:303-579-9521
Mailing Address - Fax:
Practice Address - Street 1:500 KIMBARK ST STE 200
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-5585
Practice Address - Country:US
Practice Address - Phone:303-651-1515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-22
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9926151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical