Healthcare Provider Details

I. General information

NPI: 1992502470
Provider Name (Legal Business Name): JENNIFER MARIE COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2025
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3045 E LONG CIR S
CENTENNIAL CO
80122-3341
US

IV. Provider business mailing address

PO BOX 2076
CENTENNIAL CO
80161-2076
US

V. Phone/Fax

Practice location:
  • Phone: 307-760-0422
  • Fax:
Mailing address:
  • Phone: 970-658-0883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER MARIE BANKS
Title or Position: OWNER
Credential: LPC
Phone: 970-658-0883