Provider Demographics
NPI:1053013201
Name:RIEDEL, JENNIFER (LPC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:RIEDEL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5460 WARD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-1830
Mailing Address - Country:US
Mailing Address - Phone:719-647-7178
Mailing Address - Fax:
Practice Address - Street 1:5460 WARD RD STE 100
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-1830
Practice Address - Country:US
Practice Address - Phone:719-647-7178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0019061101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional