Provider Demographics
NPI:1952182487
Name:GAZAWAY, JENNIFER (LPCC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:GAZAWAY
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 1:504 PERRY ST # A
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-1728
Mailing Address - Country:US
Mailing Address - Phone:720-680-7849
Mailing Address - Fax:
Practice Address - Street 1:504 PERRY ST # A
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-1728
Practice Address - Country:US
Practice Address - Phone:720-680-7849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-10
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0019054101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional