MEDICARE: JENNIFER A THORSTAD LPC (COLORADO)

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	101YP2500X	Professional Counselor	8088	NC
2	101YP2500X	Professional Counselor	LPC0013309	CO

General Provider Information

NPI Number	:	1528362209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER A THORSTAD LPC (COLORADO)

Provider Business Mailing Address
First Line	:	1754 N LAFAYETTE ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80218-1117
Country	:	US
Telephone Number	:	303-989-5534
Fax Number	:

Provider Business Practice Location Address
First Line	:	1754 N LAFAYETTE ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80218-1117
Country	:	US
Telephone Number	:	303-989-5534
Fax Number	:

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

Provider Enumeration Date	:	01/10/2011
Last Update Date	:	03/28/2024

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