Provider Demographics
NPI:1093592404
Name:BOON, JESSICA (LPCC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:BOON
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1280 N LAFAYETTE ST APT 703
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-2371
Mailing Address - Country:US
Mailing Address - Phone:571-229-6785
Mailing Address - Fax:
Practice Address - Street 1:7550 WEST YALE AVENUE BLDG B
Practice Address - Street 2:STE 100
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80227
Practice Address - Country:US
Practice Address - Phone:303-935-4689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0020426101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor