Provider Demographics
NPI:1881622249
Name:HAYDEN, JENNIFER H (LAC, LPC)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:H
Last Name:HAYDEN
Suffix:
Gender:F
Credentials:LAC, LPC
Other - Prefix:MRS
Other - First Name:JENNIFER
Other - Middle Name:H
Other - Last Name:SCHMIDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCC-S, LICDC-CS
Mailing Address - Street 1:9332 US HIGHWAY 50
Mailing Address - Street 2:
Mailing Address - City:HOWARD
Mailing Address - State:CO
Mailing Address - Zip Code:81233-9625
Mailing Address - Country:US
Mailing Address - Phone:719-221-1553
Mailing Address - Fax:833-932-6277
Practice Address - Street 1:245 E RAINBOW BLVD STE 11
Practice Address - Street 2:
Practice Address - City:SALIDA
Practice Address - State:CO
Practice Address - Zip Code:81201-2519
Practice Address - Country:US
Practice Address - Phone:719-626-1441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0007761101YP2500X
CO0011411101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000356690Medicare UPIN