Provider Demographics
NPI:1679393425
Name:MASSON, JENNIFER SHEREE (LPC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:SHEREE
Last Name:MASSON
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 1:14 CORNELL CIR
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81005-1914
Mailing Address - Country:US
Mailing Address - Phone:719-248-7864
Mailing Address - Fax:
Practice Address - Street 1:14 CORNELL CIR
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81005-1914
Practice Address - Country:US
Practice Address - Phone:719-248-7864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-16
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0021392101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health