Healthcare Provider Details

I. General information

NPI: 1376996694
Provider Name (Legal Business Name): JESSIE LYNN COMSTOCK LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2016
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2460 W 26TH AVE STE 30C
DENVER CO
80211-5340
US

IV. Provider business mailing address

2460 W 26TH AVE STE 30C
DENVER CO
80211-5340
US

V. Phone/Fax

Practice location:
  • Phone: 720-306-1383
  • Fax: 719-309-0911
Mailing address:
  • Phone: 720-306-1383
  • Fax: 719-309-0911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0003055
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: