Provider Demographics
NPI:1891972170
Name:LUCCHESI, JENNIFER RHODA (PSYD, LP)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:RHODA
Last Name:LUCCHESI
Suffix:
Gender:
Credentials:PSYD, LP
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:LUCCHESI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:363 VALLE ESCONDIDO DR
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81303-7960
Mailing Address - Country:US
Mailing Address - Phone:719-331-3816
Mailing Address - Fax:
Practice Address - Street 1:363 VALLE ESCONDIDO DR
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81303-7960
Practice Address - Country:US
Practice Address - Phone:719-331-3816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-29
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY.0004178103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical