Individual
JENILLE ANN GUDAHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LAC
Contact information
Practice address
751 HORIZON CT STE 111, GRAND JCT, CO 81506-8718
(970) 361-1038
(970) 644-5147
Mailing address
598 SHOSHONE ST, GRAND JCT, CO 81504-5681
(970) 361-1038
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
ACD.0000936
CO
101YP2500X
Professional Counselor
Primary
LPC.0015498
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000161929
—
CO
Enumeration date
11/05/2015
Last updated
04/03/2026
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