Provider Demographics
NPI:1255582185
Name:TINNISWOOD, JONATHAN CHARLES (MA LPC)
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:CHARLES
Last Name:TINNISWOOD
Suffix:
Gender:M
Credentials:MA LPC
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Mailing Address - Street 1:9982 E IDAHO CIR APT 101
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-6296
Mailing Address - Country:US
Mailing Address - Phone:303-832-6622
Mailing Address - Fax:303-863-0705
Practice Address - Street 1:455 ACOMA ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-5112
Practice Address - Country:US
Practice Address - Phone:303-780-9191
Practice Address - Fax:303-780-9192
Is Sole Proprietor?:No
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
COLPC-5077101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional