Provider Demographics
NPI:1053918326
Name:KAPP, JENNA RANAE (LCSW)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:RANAE
Last Name:KAPP
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4318 E UTAH PL
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-4425
Mailing Address - Country:US
Mailing Address - Phone:515-494-3745
Mailing Address - Fax:
Practice Address - Street 1:3658 N PERRY PARK RD
Practice Address - Street 2:
Practice Address - City:SEDALIA
Practice Address - State:CO
Practice Address - Zip Code:80135-8601
Practice Address - Country:US
Practice Address - Phone:970-531-6470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-08
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0009922611104100000X
1041C0700X
COCSW.099289091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker