MEDICARE: JENNIFER L NEWELL LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	0001395	CO
2	106H00000X	Marriage & Family Therapist	257	HI

General Provider Information

NPI Number	:	1184050536
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER L NEWELL LMFT

Provider Business Mailing Address
First Line	:	15595 COPPERFIELD DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80921-3526
Country	:	US
Telephone Number	:	808-358-3910
Fax Number	:

Provider Business Practice Location Address
First Line	:	1465 KELLY JOHNSON BLVD STE 350
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-3983
Country	:	US
Telephone Number	:	808-358-3910
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/17/2013
Last Update Date	:	02/24/2024

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