Healthcare Provider Details

I. General information

NPI: 1306740188
Provider Name (Legal Business Name): JESSICA BUTCHER EISENBERG LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6420 W 108TH PL
WESTMINSTER CO
80020-3129
US

IV. Provider business mailing address

6420 W 108TH PL
WESTMINSTER CO
80020-3129
US

V. Phone/Fax

Practice location:
  • Phone: 703-863-5796
  • Fax:
Mailing address:
  • Phone: 703-863-5796
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC0022118
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: