Provider Demographics
NPI:1144632647
Name:HUBBARD, JENNIFER
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8175 SHERIDAN BLVD UNIT N
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80003-1928
Mailing Address - Country:US
Mailing Address - Phone:303-557-0855
Mailing Address - Fax:
Practice Address - Street 1:8175 SHERIDAN BLVD UNIT N
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80003-1928
Practice Address - Country:US
Practice Address - Phone:303-557-0855
Practice Address - Fax:720-336-3149
Is Sole Proprietor?:No
Enumeration Date:2014-06-02
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099246121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical