Provider Demographics
NPI:1487959201
Name:LEBRUN-MORRILL, JENNIFER N (MA, LPC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:N
Last Name:LEBRUN-MORRILL
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:N
Other - Last Name:RUIZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:220 RUSKIN DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80910
Mailing Address - Country:US
Mailing Address - Phone:719-572-6100
Mailing Address - Fax:719-572-6080
Practice Address - Street 1:179 PARKSIDE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910
Practice Address - Country:US
Practice Address - Phone:719-572-6100
Practice Address - Fax:719-572-6399
Is Sole Proprietor?:No
Enumeration Date:2011-01-26
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10064101Y00000X
101Y00000X
CO11237101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor