Provider Demographics
NPI:1093131245
Name:ALSIP, JESSICA TABOADA (LCSW)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:TABOADA
Last Name:ALSIP
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:KAY
Other - Last Name:TABOADA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:10900 W 44TH AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-2761
Mailing Address - Country:US
Mailing Address - Phone:303-940-9999
Mailing Address - Fax:303-459-5556
Practice Address - Street 1:10900 W 44TH AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-2761
Practice Address - Country:US
Practice Address - Phone:303-940-9999
Practice Address - Fax:303-459-5556
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-12
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW10781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical