Healthcare Provider Details

I. General information

NPI: 1841194271
Provider Name (Legal Business Name): JENNIFER BYRNETT MA, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6610 GUNPARK DR STE 202
BOULDER CO
80301-3579
US

IV. Provider business mailing address

3035 17TH AVE APT 3
LONGMONT CO
80503-1653
US

V. Phone/Fax

Practice location:
  • Phone: 860-818-2233
  • Fax:
Mailing address:
  • Phone: 860-818-2233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC.0025323
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: