Provider Demographics
NPI:1104223239
Name:SMALLEY, JAMIE (MA, LPC)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:SMALLEY
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:GIUFFRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:364 MONARCH ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-1230
Mailing Address - Country:US
Mailing Address - Phone:303-818-2585
Mailing Address - Fax:
Practice Address - Street 1:1333 IRIS AVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-2226
Practice Address - Country:US
Practice Address - Phone:303-449-6029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-04
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0012218101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool