Provider Demographics
NPI:1508435728
Name:SALAZAR, JESSICA (LPCC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:SALAZAR
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 S STEELE ST STE 810
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-2805
Mailing Address - Country:US
Mailing Address - Phone:720-515-1229
Mailing Address - Fax:
Practice Address - Street 1:50 S STEELE ST STE 810
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-2805
Practice Address - Country:US
Practice Address - Phone:720-515-1229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
COS604883Medicaid