Healthcare Provider Details

I. General information

NPI: 1780591008
Provider Name (Legal Business Name): JESSE WHITNEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 S ONEIDA ST
DENVER CO
80224-2549
US

IV. Provider business mailing address

2121 S ONEIDA ST
DENVER CO
80224-2549
US

V. Phone/Fax

Practice location:
  • Phone: 720-863-6100
  • Fax:
Mailing address:
  • Phone: 720-863-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0021188
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0023044
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: