Provider Demographics
NPI:1427118256
Name:BOCK, JENNIFER C (LPC)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:C
Last Name:BOCK
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 1:5500 S SYCAMORE ST
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-8201
Mailing Address - Country:US
Mailing Address - Phone:303-347-6439
Mailing Address - Fax:303-797-9357
Practice Address - Street 1:5500 S SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-8201
Practice Address - Country:US
Practice Address - Phone:303-347-6439
Practice Address - Fax:303-797-9357
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3687101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health