Healthcare Provider Details

I. General information

NPI: 1730710054
Provider Name (Legal Business Name): JESSICA ALLEN PH.D., LP, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA PEARSON-ALLEN PH.D., LP, BCBA

II. Dates (important events)

Enumeration Date: 01/27/2020
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2912 BEACON ST STE 110
COLORADO SPRINGS CO
80907-9207
US

IV. Provider business mailing address

2912 BEACON ST STE 110
COLORADO SPRINGS CO
80907-9207
US

V. Phone/Fax

Practice location:
  • Phone: 719-377-8030
  • Fax: 855-876-2030
Mailing address:
  • Phone: 214-701-0158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number6219
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1327
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number39861
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number6219
License Number StateCO
# 5
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number6219
License Number StateCO
# 6
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number6219
License Number StateCO
# 7
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number6219
License Number StateCO
# 8
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6219
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: