Provider Demographics
NPI:1497361646
Name:OLGUIN, JESSICA A (LPC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:A
Last Name:OLGUIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6901 S PIERCE ST STE 370
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-7202
Mailing Address - Country:US
Mailing Address - Phone:720-515-6385
Mailing Address - Fax:
Practice Address - Street 1:6901 S PIERCE ST STE 370
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80128-7202
Practice Address - Country:US
Practice Address - Phone:720-515-6385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-22
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0000705101YA0400X
COLPC.0014170101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000211721Medicaid