MEDICARE: JESSE L SCHRAMM LPC, SOMB

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LPC-0012166	CO

General Provider Information

NPI Number	:	1043639305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSE L SCHRAMM LPC, SOMB

Provider Business Mailing Address
First Line	:	8191 SOUTHPARK LN UNIT 201
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80120-4641
Country	:	US
Telephone Number	:	303-726-4560
Fax Number	:

Provider Business Practice Location Address
First Line	:	8191 SOUTHPARK LN UNIT 201
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80120-4641
Country	:	US
Telephone Number	:	303-726-4560
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/15/2014
Last Update Date	:	01/02/2023

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