Provider Demographics
NPI:1215241286
Name:AMARAL-KUNZE, JENNIFER SUSAN (LPC)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:SUSAN
Last Name:AMARAL-KUNZE
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 1:2627 REDWING RD STE 250
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-6329
Mailing Address - Country:US
Mailing Address - Phone:970-413-2264
Mailing Address - Fax:970-788-7600
Practice Address - Street 1:2627 REDWING RD STE 250
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-6329
Practice Address - Country:US
Practice Address - Phone:970-413-2264
Practice Address - Fax:970-788-7600
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-02
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5065101YM0800X
CO101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1265661169OtherGROUP NPI BEYOND THE MIRROR