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General NPI Number Information
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NPI Number | 1366866337
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Entity Type | Individual
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Provider Name | JENNIFER ANNE COLBERG LPC, LMFT
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Gender | Female
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Dates
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Enumeration Date | 02/12/2014
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Last Update Date | 10/14/2015
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Provider Practice Location Address
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Address Line | 181 EMMETT ST W
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City | BATTLE CREEK
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State | MI
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Zip | 49037-2963
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Country | US
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Telephone | 269-966-2600
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Fax | 269-965-4773
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Provider Business Mailing Address
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Address Line | 181 EMMETT ST W
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City | BATTLE CREEK
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State | MI
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Zip | 49037-2963
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Country | US
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Telephone | 269-966-2600
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Fax | 269-965-4773
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 6401012491
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 4101006564
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License Number State | MI
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