Provider Demographics
NPI:1174881742
Name:YOUNG, JENNIFER (MA, GCDF)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MA, GCDF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12101 E 2ND AVE
Mailing Address - Street 2:203
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-8327
Mailing Address - Country:US
Mailing Address - Phone:720-233-6765
Mailing Address - Fax:
Practice Address - Street 1:12101 E 2ND AVE
Practice Address - Street 2:203
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-8327
Practice Address - Country:US
Practice Address - Phone:720-233-6765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO13911101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health