Provider Demographics
NPI:1295215945
Name:TRUITT, JESSICA (MA, LPC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:TRUITT
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:TRUITT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5109 N YAMPA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80249-8146
Mailing Address - Country:US
Mailing Address - Phone:443-614-5984
Mailing Address - Fax:
Practice Address - Street 1:5109 N YAMPA ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80249-8146
Practice Address - Country:US
Practice Address - Phone:443-614-5984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-21
Last Update Date:2023-11-02
Deactivation Date:2020-03-19
Deactivation Code:
Reactivation Date:2020-06-09
Provider Licenses
StateLicense IDTaxonomies
COLPC.0017664101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional