Healthcare Provider Details

I. General information

NPI: 1346153731
Provider Name (Legal Business Name): JESSE SUNSHINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 S BLACKHAWK ST STE 240
AURORA CO
80014-1475
US

IV. Provider business mailing address

2101 S BLACKHAWK ST STE 240
AURORA CO
80014-1475
US

V. Phone/Fax

Practice location:
  • Phone: 720-442-9025
  • Fax: 720-405-4257
Mailing address:
  • Phone: 720-442-9025
  • Fax: 720-405-4257

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: JESSICA S LYON
Title or Position: INDIVIDUAL THERAPIST
Credential: MSW
Phone: 720-442-9025