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General NPI Number Information
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NPI Number | 1790493302
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Entity Type | Individual
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Provider Name | JESSICA ALYSE CARPENTER
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Gender | Female
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Dates
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Enumeration Date | 11/11/2022
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 750 W HAMPDEN AVE STE 375
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City | ENGLEWOOD
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State | CO
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Zip | 80110-2221
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Country | US
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Telephone | 303-578-6318
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Fax |
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Provider Business Mailing Address
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Address Line | 1468 JAY ST
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City | LAKEWOOD
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State | CO
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Zip | 80214-2021
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Country | US
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Telephone | 678-332-7412
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC.0022618
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License Number State | CO
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