Gudahl, Jenille Ann

Gudahl, Jenille Ann is an sole proprietor health care provider with primary practice located at 800 Belford Ave Ste 200A , Grand Jct CO 81501-3100. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Gudahl, Jenille Ann can be contacted via phone (970) 361-1038.

Contact Information

Primary practice address
800 Belford Ave Ste 200A Grand Jct CO 81501-3100
Phone: (970) 361-1038
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X LPC.0015498 Colorado
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X ACD.0000936 Colorado

Profile Details

NPI number 1386017812
LBN Legal business name Gudahl, Jenille Ann
Credentials LPC, LAC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 5th, 2015
Last updated Nov 17th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386017812 NPPES
Colorado MEDICAID 9000161929

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