Provider Demographics
NPI:1851808240
Name:KIRCHBERG, JESSICA S (LCPC (IL), LPC (CO))
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:S
Last Name:KIRCHBERG
Suffix:
Gender:F
Credentials:LCPC (IL), LPC (CO)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5618 YARROW ST
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-2442
Mailing Address - Country:US
Mailing Address - Phone:224-377-0390
Mailing Address - Fax:
Practice Address - Street 1:2950 W CHICAGO AVE STE 202
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-4377
Practice Address - Country:US
Practice Address - Phone:224-377-0390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-07
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0017642101YP2500X
IL180.013805101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional