Individual
JENNIFER AMIDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3579 POLK CIR E, WELLINGTON, CO 80549-1682
(970) 556-2645
Mailing address
3579 POLK CIR E, WELLINGTON, CO 80549-1682
(970) 556-2645
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0009922195
CO
104100000X
Social Worker
0009922195
CO
1041C0700X
Clinical Social Worker
Primary
09927954
CO
Other
Enumeration date
02/14/2019
Last updated
02/13/2024
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