Provider Demographics
NPI:1497427041
Name:JACKSON, KRISTEN (PSYCHOTHERAPIST)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:JACKSON
Suffix:
Gender:F
Credentials:PSYCHOTHERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9753 E 60TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80238-2394
Mailing Address - Country:US
Mailing Address - Phone:303-931-0606
Mailing Address - Fax:
Practice Address - Street 1:720 SOUTH COLORADO BLVD.
Practice Address - Street 2:NORTH TOWER # 1356
Practice Address - City:GLENDALE
Practice Address - State:CO
Practice Address - Zip Code:80246
Practice Address - Country:US
Practice Address - Phone:303-931-0606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-01
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health