Provider Demographics
NPI:1548084742
Name:PETERS, JENNIFER DANIELLE (MA, MA, LPC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:DANIELLE
Last Name:PETERS
Suffix:
Gender:F
Credentials:MA, MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1794 ASPEN MEADOWS CIR
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80260-4802
Mailing Address - Country:US
Mailing Address - Phone:720-648-5058
Mailing Address - Fax:
Practice Address - Street 1:1794 ASPEN MEADOWS CIR
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80260-4802
Practice Address - Country:US
Practice Address - Phone:720-648-5058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0021501101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor