Healthcare Provider Details

I. General information

NPI: 1285349183
Provider Name (Legal Business Name): JADYN ROSE MADDEN LPC ASSOCIATE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2023
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6685 GUNPARK DR STE 110T
BOULDER CO
80301-3343
US

IV. Provider business mailing address

3000 POLAR LN STE 501
CEDAR PARK TX
78613-3073
US

V. Phone/Fax

Practice location:
  • Phone: 303-415-4299
  • Fax:
Mailing address:
  • Phone: 512-400-4321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0022069
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number87964
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: