Basic Information
| Provider Information | |||||||||
| NPI: | 1407320294 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MONKS | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | JAYE | ||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | KENDALL | ||||||||
| OtherFirstName: | JENNIFER | ||||||||
| OtherMiddleName: | J | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1608 SUMMERNIGHT TER | ||||||||
| Address2: | |||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809092730 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7197615972 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1608 SUMMERNIGHT TER | ||||||||
| Address2: | |||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809092730 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7192661000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/15/2019 | ||||||||
| LastUpdateDate: | 07/14/2020 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/14/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | N | 101YM0800X | LPCC.0017577 | CO | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.