Provider Demographics
NPI:1306007513
Name:KETTWICK, JASMYNE A (MAMFT, LMFT)
Entity type:Individual
Prefix:MS
First Name:JASMYNE
Middle Name:A
Last Name:KETTWICK
Suffix:
Gender:F
Credentials:MAMFT, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 INVERNESS DR S STE 201
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-6012
Mailing Address - Country:US
Mailing Address - Phone:303-954-9809
Mailing Address - Fax:
Practice Address - Street 1:327 INVERNESS DR S STE 201
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-6012
Practice Address - Country:US
Practice Address - Phone:303-954-9809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-19
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLMFT1160106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist