Jeremy John Senn, MA,LPC,LAC,NCC,MAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4772 Issued in CO

Practice address

4076 Neely Road
BLDG 4076, Room 3C-401
Ft Wainwright, AK 99703

Phone

(907) 384-0405

NPI assigned

Oct 10, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1972791317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4076 NEELY ROAD",
            "address_2": "BLDG 4076, ROOM 3C-401",
            "city": "FT WAINWRIGHT",
            "state": "AK",
            "postal_code": "99703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4076 NEELY ROAD",
            "address_2": "BLDG 4076, ROOM 3C-401",
            "city": "FT WAINWRIGHT",
            "state": "AK",
            "postal_code": "99703",
            "telephone_number": "907-384-0405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7251 W 20th St",
            "address_2": "M-2",
            "address_purpose": "LOCATION",
            "city": "Greeley",
            "state": "CO",
            "postal_code": "806344625",
            "country_code": "US",
            "telephone_number": "970-691-1726",
            "fax_number": "970-351-0182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SENN",
        "first_name": "JEREMY",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "MA,LPC,LAC,NCC,MAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-10",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "200",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "4772",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "4772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Victor Sanchez, DDS
• Amber Rose O'Barr Sanders, LAT, ATC
• Meagen Sassman, RD
• Janice Schroeder, RN
• Morgan Schwoch, MD
• Kenneth A Sheafer
• Leah Sheaffer, CRNA
• Rebecca Lynn Grinsell Sheridan, M.D.
• Karlene Pimentel Sierra, FNP-BC
• Brando R Sipin

• Mental Health Counselor in Fort Wainwright, AK
• Providers in Fort Wainwright, AK by specialty
• Mental Health Counselor in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.