MEDICARE: JENIFER SHOTT LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LPCC.0014752	CO
2	101YM0800X	Mental Health Counselor	LPC.0015419	CO

General Provider Information

NPI Number	:	1255784534
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENIFER SHOTT LPC

Provider Business Mailing Address
First Line	:	6565 W JEWELL AVE STE 2
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80232-7102
Country	:	US
Telephone Number	:	720-900-5358
Fax Number	:

Provider Business Practice Location Address
First Line	:	6565 W JEWELL AVE STE 2
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80232-7102
Country	:	US
Telephone Number	:	720-900-5358
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2016
Last Update Date	:	07/18/2019

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Directions to “ JENIFER SHOTT LPC” Practice Location

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