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General NPI Number Information
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NPI Number | 1629556881
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Entity Type | Individual
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Provider Name | JENNIFER MARIE STANGA MSW, LCSW, DBH
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Gender | Female
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Dates
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Enumeration Date | 07/31/2018
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Last Update Date | 09/05/2024
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Provider Practice Location Address
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Address Line | 13731 E RICE PL STE 200
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City | AURORA
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State | CO
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Zip | 80015-1077
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Country | US
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Telephone | 720-949-1707
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Fax |
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Provider Business Mailing Address
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Address Line | 134 COYOTE ST
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City | BENNETT
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State | CO
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Zip | 80102-8782
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Country | US
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Telephone | 719-649-5573
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 09930714
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License Number State | CO
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