MEDICARE: JENNIFER THOMAS FRITZLER LCSW

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	1041C0700X	Clinical Social Worker	989496	CO

General Provider Information

NPI Number	:	1528177318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER THOMAS FRITZLER LCSW

Provider Business Mailing Address
First Line	:	11585 DEWEY ST
Second Line	:
City	:	PARKER
State	:	CO
Zip	:	80138-3913
Country	:	US
Telephone Number	:	970-380-7234
Fax Number	:	970-867-7234

Provider Business Practice Location Address
First Line	:	324 E RAILROAD AVE
Second Line	:	SUITE 500
City	:	FORT MORGAN
State	:	CO
Zip	:	80701-3145
Country	:	US
Telephone Number	:	970-867-7234
Fax Number	:	970-867-7234

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

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	05/18/2023

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