Provider Demographics
NPI:1396378725
Name:JESS KAHNKE LLC
Entity Type:Organization
Organization Name:JESS KAHNKE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMFT
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAHNKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-443-1766
Mailing Address - Street 1:3840 HAUPTMAN CT
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-6006
Mailing Address - Country:US
Mailing Address - Phone:612-867-7008
Mailing Address - Fax:
Practice Address - Street 1:2855 N SPEER BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-4239
Practice Address - Country:US
Practice Address - Phone:720-443-1766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-13
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)