Provider Demographics
NPI:1154506053
Name:PARKER-SHARP, JESSICA NANCE DARLENE (MS, LPC)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:NANCE DARLENE
Last Name:PARKER-SHARP
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:MISS
Other - First Name:JESSICA
Other - Middle Name:NANCE D
Other - Last Name:PARKER, MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:220 RUSKIN DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80910
Mailing Address - Country:US
Mailing Address - Phone:719-572-6100
Mailing Address - Fax:719-572-6080
Practice Address - Street 1:115 S PARKSIDE DRIVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910
Practice Address - Country:US
Practice Address - Phone:719-572-6340
Practice Address - Fax:719-447-4792
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
CO5696101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional