MEDICARE: JESSICA QUICK WELLNESS

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1427672054
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JESSICA QUICK WELLNESS

Provider Business Mailing Address
First Line	:	1432 S VINE ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80210-2337
Country	:	US
Telephone Number	:	315-725-8687
Fax Number	:

Provider Business Practice Location Address
First Line	:	1432 S VINE ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80210-2337
Country	:	US
Telephone Number	:	315-725-8687
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST/MENTAL HEALTH PROVIDER
Name	:	JESSICA QUICK
Credential	:	LCSW
Telephone Number	:	315-725-8687

Provider Enumeration Date	:	05/29/2020
Last Update Date	:	05/29/2020

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Directions to “JESSICA QUICK WELLNESS ” Practice Location

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