Provider Demographics
NPI:1205532413
Name:KOLOGE, JENNIE (LPCC)
Entity type:Individual
Prefix:
First Name:JENNIE
Middle Name:
Last Name:KOLOGE
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 S BRENTWOOD ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-1355
Mailing Address - Country:US
Mailing Address - Phone:254-498-4017
Mailing Address - Fax:
Practice Address - Street 1:7112 W JEFFERSON AVE STE 307
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80235-2328
Practice Address - Country:US
Practice Address - Phone:254-498-4017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0018936101YM0800X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health