Provider Demographics
NPI:1033308143
Name:BRIDGES, JENNY (LCSW, ACSW, CEAP)
Entity type:Individual
Prefix:MS
First Name:JENNY
Middle Name:
Last Name:BRIDGES
Suffix:
Gender:F
Credentials:LCSW, ACSW, CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 260495
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-0495
Mailing Address - Country:US
Mailing Address - Phone:720-350-1109
Mailing Address - Fax:720-524-8024
Practice Address - Street 1:7400 W 14TH AVE STE 6
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80214-4234
Practice Address - Country:US
Practice Address - Phone:720-350-1109
Practice Address - Fax:720-350-1109
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-15
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9890091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
000229OtherCEAP