Provider Demographics
NPI:1801948971
Name:EPSTEIN, JENNIFER A (MA, LPC, R-DMT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:A
Last Name:EPSTEIN
Suffix:
Gender:F
Credentials:MA, LPC, R-DMT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:EPSTEIN
Other - Last Name:KESSEM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, LPC, R-DMT
Mailing Address - Street 1:1910 7TH ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-5026
Mailing Address - Country:US
Mailing Address - Phone:303-847-5356
Mailing Address - Fax:
Practice Address - Street 1:1910 7TH ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-5026
Practice Address - Country:US
Practice Address - Phone:303-847-5356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4214101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health