Healthcare Provider Details

I. General information

NPI: 1093218216
Provider Name (Legal Business Name): JESSICA LYNN BLOUNT LPC, LAC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2018
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 IOWA AVE STE 4
COLORADO SPRINGS CO
80909-5947
US

IV. Provider business mailing address

3764 CHIA DR
COLORADO SPRINGS CO
80925-1379
US

V. Phone/Fax

Practice location:
  • Phone: 719-358-7338
  • Fax:
Mailing address:
  • Phone: 719-440-6283
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0015272
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberACD.0001305
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: