Healthcare Provider Details

I. General information

NPI: 1063399194
Provider Name (Legal Business Name): JENNIFER LILLIE LPCC, ATR-P
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNI LILLIE

II. Dates (important events)

Enumeration Date: 08/20/2025
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7655 W MISSISSIPPI AVE # 310
LAKEWOOD CO
80226-4356
US

IV. Provider business mailing address

705 JARVIS DR
ERIE CO
80516-2483
US

V. Phone/Fax

Practice location:
  • Phone: 720-485-3756
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number25-407
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0023841
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: