Healthcare Provider Details

I. General information

NPI: 1962349357
Provider Name (Legal Business Name): JESSICA GIULI AUSTIN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2026
Last Update Date: 05/02/2026
Certification Date: 05/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6640 GUNPARK DR STE 101
BOULDER CO
80301-7001
US

IV. Provider business mailing address

1068 KALMIA AVE
BOULDER CO
80304-1744
US

V. Phone/Fax

Practice location:
  • Phone: 720-400-7854
  • Fax:
Mailing address:
  • Phone: 720-320-3440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0023781
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: