Jenna Koors, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

JENNA KOORS, LLC

Practice address

20 Kelly Lynn Dr
Sandia Park, NM 87047-9326

Phone

(505) 363-9373

NPI assigned

Sep 2, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Miss Jenna Marie Koors, LCSWNPI 1992181416

Title

Psychotherapist/Ceo

Phone

(505) 363-9373

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jenna Marie Koors, LMSW

  • Social Worker
  • Albuquerque, NM
  • NPI 1992181416

  NM

  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1725235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725235200000",
    "number": "1801620729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 KELLY LYNN DR",
            "city": "SANDIA PARK",
            "state": "NM",
            "postal_code": "870479326",
            "telephone_number": "505-363-9373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 KELLY LYNN DR",
            "city": "SANDIA PARK",
            "state": "NM",
            "postal_code": "870479326",
            "telephone_number": "505-363-9373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNA KOORS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-02",
        "last_updated": "2024-09-02",
        "certification_date": "2024-09-01",
        "status": "A",
        "authorized_official_last_name": "KOORS",
        "authorized_official_first_name": "JENNA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST/CEO",
        "authorized_official_telephone_number": "505-363-9373",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin K Geddes, MA, CCC-SLP
• Alison Faith Henley
• Timothy Edward Henley, PA
• Lynn Andre Henrickson, M.D.
• Jean Vanessa Holley, LPCC
• Holly Kidwell
• Gabrielle Martinez, LMHC
• McKenna Dawn Marie Matins, BSN, RN; BIRTH DOULA
• Caesar Morales, OT
• Elizabeth Ann Morgan, MD

• All providers in Sandia Park, NM
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.