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General NPI Number Information
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NPI Number | 1235762857
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Entity Type | Individual
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Provider Name | JESSICA JIMENEZ LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/21/2020
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Last Update Date | 09/17/2021
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Provider Practice Location Address
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Address Line | 2855 N SPEER BLVD STE D
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City | DENVER
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State | CO
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Zip | 80211-4240
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Country | US
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Telephone | 303-396-8498
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Fax |
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Provider Business Mailing Address
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Address Line | 1124 S UNIVERSITY BLVD
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City | DENVER
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State | CO
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Zip | 80210-1907
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Country | US
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Telephone | 303-907-4629
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | LSW.0009922443
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW.09927400
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License Number State | CO
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