Basic Information
Provider Information
NPI: 1508373945
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JOBE
FirstName: LAUREN
MiddleName: JANEEN
NamePrefix:  
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: PINNEO
OtherFirstName: LAUREN
OtherMiddleName: JANEEN
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: LCSW
OtherLastNameType: 1
Mailing Information
Address1: 11059 E BETHANY DR
Address2:  
City: AURORA
State: CO
PostalCode: 800142622
CountryCode: US
TelephoneNumber: 3036172300
FaxNumber: 3036172365
Practice Location
Address1: 11059 E BETHANY DR
Address2:  
City: AURORA
State: CO
PostalCode: 800142622
CountryCode: US
TelephoneNumber: 3036172300
FaxNumber: 3036172365
Other Information
ProviderEnumerationDate: 01/08/2018
LastUpdateDate: 01/17/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700XCSW.00001846COY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


Home