=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982745352
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JENNIFER ANN BURNS LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/09/2007
-----------------------------------------------------
Last Update Date | 02/08/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7851 S ELATI ST STE 207
-----------------------------------------------------
City | LITTLETON
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80120-8080
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-521-0147
-----------------------------------------------------
Fax | 888-598-3113
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3290 LYNWOOD AVE
-----------------------------------------------------
City | HIGHLANDS RANCH
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80126-8044
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-521-0147
-----------------------------------------------------
Fax | 888-598-3113
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 290
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------