Provider Demographics
NPI:1134282510
Name:DEGROFF, JENNIFER E (PHD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:E
Last Name:DEGROFF
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:E
Other - Last Name:CATO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10TH MDG
Mailing Address - Street 2:4102 PINION DR
Mailing Address - City:USAF ACADEMY
Mailing Address - State:CO
Mailing Address - Zip Code:80840
Mailing Address - Country:US
Mailing Address - Phone:719-333-5115
Mailing Address - Fax:
Practice Address - Street 1:10TH MDG
Practice Address - Street 2:4102 PINION DRIVE
Practice Address - City:USAFA
Practice Address - State:CO
Practice Address - Zip Code:80840
Practice Address - Country:US
Practice Address - Phone:719-306-3342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3043103T00000X
COPSY-3043103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO807025Medicare PIN