Healthcare Provider Details

I. General information

NPI: 1134009996
Provider Name (Legal Business Name): JADYN SPAIN MA,LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2025
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1290 S POTOMAC ST
AURORA CO
80012-4524
US

IV. Provider business mailing address

1290 CHAMBERS RD
AURORA CO
80011-7117
US

V. Phone/Fax

Practice location:
  • Phone: 303-617-2300
  • Fax:
Mailing address:
  • Phone: 303-617-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC.0023800
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC.0023800
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: