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NPI Code Detail

MEDICARE: JENNIFER LEWIS M. ED.

MEDICARE:   JENNIFER  LEWIS  M. ED.
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
1101Y00000XCounselorNLC0009316CO

General Provider Information

NPI Number : 1902552458
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER LEWIS M. ED.
Provider Business Mailing Address
First Line : 527 EDWARDS ST
Second Line :
City : FORT COLLINS
State : CO
Zip : 80524-3811
Country : US
Telephone Number : 970-227-6359
Fax Number :
Provider Business Practice Location Address
First Line : 222 W MAGNOLIA ST
Second Line :
City : FORT COLLINS
State : CO
Zip : 80521-2812
Country : US
Telephone Number : 970-490-1309
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2022
Last Update Date : 02/23/2022

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Directions to “ JENNIFER LEWIS M. ED.” Practice Location

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