Provider Demographics
NPI:1417615188
Name:MADSEN, JENNIFER L (LICSW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:MADSEN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 18TH ST APT 563
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-6439
Mailing Address - Country:US
Mailing Address - Phone:720-979-5902
Mailing Address - Fax:
Practice Address - Street 1:1080 S SABLE BLVD UNIT 17-18
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-3796
Practice Address - Country:US
Practice Address - Phone:303-552-9577
Practice Address - Fax:415-252-7176
Is Sole Proprietor?:No
Enumeration Date:2021-11-30
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1151791041C0700X
MA1241611041C0700X
COCSW.099269561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical