Healthcare Provider Details

I. General information

NPI: 1144663857
Provider Name (Legal Business Name): JENNIFER REYNOLDS MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2013
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

827 N GRANT ST
DENVER CO
80203-2902
US

IV. Provider business mailing address

827 N GRANT ST
DENVER CO
80203-2902
US

V. Phone/Fax

Practice location:
  • Phone: 303-482-5670
  • Fax:
Mailing address:
  • Phone: 303-482-5670
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number12481
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: