Provider Demographics
NPI:1124993274
Name:FRIEDMAN, JESSICA RENEE (LPPC-0023997)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:RENEE
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:LPPC-0023997
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1772 STEEL ST UNIT 3101
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-8543
Mailing Address - Country:US
Mailing Address - Phone:719-722-4044
Mailing Address - Fax:
Practice Address - Street 1:1772 STEEL ST UNIT 3101
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-8543
Practice Address - Country:US
Practice Address - Phone:719-722-4044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-08
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0023997101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health