MEDICARE: JENCEE REARDON

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	SWC.0000001908	CO

General Provider Information

NPI Number	:	1649642802
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENCEE REARDON

Provider Business Mailing Address
First Line	:	729 REMINGTON ST
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-3332
Country	:	US
Telephone Number	:	970-484-8427
Fax Number	:

Provider Business Practice Location Address
First Line	:	729 REMINGTON ST
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-3332
Country	:	US
Telephone Number	:	970-484-8427
Fax Number	:

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

Provider Enumeration Date	:	10/28/2015
Last Update Date	:	11/21/2024

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Directions to “ JENCEE REARDON ” Practice Location

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