Provider Demographics
NPI:1043946072
Name:JONELL, JENNIFER (MA)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:JONELL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6193 S FAIRFAX CT
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80121-3417
Mailing Address - Country:US
Mailing Address - Phone:720-301-4962
Mailing Address - Fax:
Practice Address - Street 1:5241 S QUEBEC ST STE 225
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-1816
Practice Address - Country:US
Practice Address - Phone:720-301-4962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-01
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0015501101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional