Healthcare Provider Details

I. General information

NPI: 1740108166
Provider Name (Legal Business Name): JILLIAN TOSTA LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3434 47TH ST STE 130
BOULDER CO
80301-1802
US

IV. Provider business mailing address

1800 30TH ST STE 212
BOULDER CO
80301-1087
US

V. Phone/Fax

Practice location:
  • Phone: 970-670-0531
  • Fax:
Mailing address:
  • Phone: 970-670-0531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC.0022128
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: