Provider Demographics
NPI:1275871014
Name:MEYER, JENNIFER A (MA, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:A
Last Name:MEYER
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1451 24TH ST
Mailing Address - Street 2:APT. 339
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-2104
Mailing Address - Country:US
Mailing Address - Phone:303-295-0590
Mailing Address - Fax:
Practice Address - Street 1:1776 S JACKSON ST
Practice Address - Street 2:SUITE 1022
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-3801
Practice Address - Country:US
Practice Address - Phone:313-574-0668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5695101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health