Healthcare Provider Details

I. General information

NPI: 1154240521
Provider Name (Legal Business Name): JENNIFER CONCIENNE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

3030 S COLLEGE AVE UNIT 200A
FORT COLLINS CO
80525-2557
US

IV. Provider business mailing address

463 SLIPPERY ELM CT
LOVELAND CO
80538-2349
US

V. Phone/Fax

Practice location:
  • Phone: 970-372-0573
  • Fax:
Mailing address:
  • Phone: 720-940-3608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC.0022708
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: