Healthcare Provider Details

I. General information

NPI: 1699366351
Provider Name (Legal Business Name): JENNIFER WANTY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2021
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 E EVANS AVE STE 210
DENVER CO
80222-5406
US

IV. Provider business mailing address

6000 E EVANS AVE STE 210
DENVER CO
80222-5406
US

V. Phone/Fax

Practice location:
  • Phone: 720-372-4832
  • Fax:
Mailing address:
  • Phone: 720-372-4832
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0016460
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: