MEDICARE: JENNIFER ANN BEACH 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	CSW.00000387	CO

General Provider Information

NPI Number	:	1598263436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER ANN BEACH LCSW

Provider Business Mailing Address
First Line	:	6000 S OAK WAY
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80127-2447
Country	:	US
Telephone Number	:	612-270-9238
Fax Number	:

Provider Business Practice Location Address
First Line	:	6901 S PIERCE ST STE 350
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80128-4554
Country	:	US
Telephone Number	:	303-801-7878
Fax Number	:	612-270-9238

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

Provider Enumeration Date	:	01/25/2018
Last Update Date	:	01/25/2018

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