Provider Demographics
NPI:1922714823
Name:WILSON, JESSICA JEAN (LPCC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:JEAN
Last Name:WILSON
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:PO BOX 473511
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80047-3511
Mailing Address - Country:US
Mailing Address - Phone:720-585-6076
Mailing Address - Fax:
Practice Address - Street 1:11059 E BETHANY DR STE 210
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2637
Practice Address - Country:US
Practice Address - Phone:303-732-6881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-25
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health