Provider Demographics
NPI:1063924504
Name:MAY, JESSICA TAYLOR (LPC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:TAYLOR
Last Name:MAY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 S BROADWAY #9950
Mailing Address - Street 2:SMB#33861
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-3882
Mailing Address - Country:US
Mailing Address - Phone:719-900-2265
Mailing Address - Fax:
Practice Address - Street 1:5415 ZAPATO DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-3822
Practice Address - Country:US
Practice Address - Phone:719-900-2265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-24
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
COLPC.0016434101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health