Healthcare Provider Details

I. General information

NPI: 1588199970
Provider Name (Legal Business Name): JENNIFER DAVIS PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENNIFER GLIDEWELL

II. Dates (important events)

Enumeration Date: 04/24/2017
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 W PEAKVIEW AVE
LITTLETON CO
80120-3441
US

IV. Provider business mailing address

655 W PEAKVIEW AVE
LITTLETON CO
80120-3441
US

V. Phone/Fax

Practice location:
  • Phone: 303-909-6893
  • Fax:
Mailing address:
  • Phone: 303-909-6893
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number4415
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPS02064
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number4415
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number4415
License Number StateCO
# 5
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number4415
License Number StateCO
# 6
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number4415
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: