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General NPI Number Information
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NPI Number | 1932600434
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Entity Type | Individual
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Provider Name | JENNIFER LYNN HEAD LCSW, MSW
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Gender | Female
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Dates
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Enumeration Date | 02/21/2018
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 2629 REDWING RD STE 270
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City | FORT COLLINS
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State | CO
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Zip | 80526-2879
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Country | US
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Telephone | 970-462-9020
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 22
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City | FORT COLLINS
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State | CO
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Zip | 80522-0022
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Country | US
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Telephone | 970-494-4200
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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 | CSW.09926555
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License Number State | CO
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