MEDICARE: MISS JESSYCA SONIA STERNER MA, LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	0005802	CO

General Provider Information

NPI Number	:	1639595382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS JESSYCA SONIA STERNER MA, LPC

Provider Business Mailing Address
First Line	:	4940 CHARIOT DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80923
Country	:	US
Telephone Number	:	719-201-3482
Fax Number	:	719-356-7060

Provider Business Practice Location Address
First Line	:	5265 N ACADEMY BLVD STE 3300
Second Line	:
City	:	COLORADO SPGS
State	:	CO
Zip	:	80918-4082
Country	:	US
Telephone Number	:	719-201-3482
Fax Number	:	719-356-7060

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2014
Last Update Date	:	05/20/2021

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