Provider Demographics
NPI:1750027645
Name:SISNEROS, JESSICA ANN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:ANN
Last Name:SISNEROS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:JESSICA
Other - Middle Name:ANN
Other - Last Name:ARCHULETA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:2860 S CIRCLE DR STE 103B
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-4113
Mailing Address - Country:US
Mailing Address - Phone:719-540-2100
Mailing Address - Fax:
Practice Address - Street 1:2860 S CIRCLE DR STE 103B
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-4113
Practice Address - Country:US
Practice Address - Phone:719-540-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-12
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0014058101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional