MEDICARE: MS. JESSICA GRAVES MA, LPC, BCB

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	0004449	CO

General Provider Information

NPI Number	:	1770548638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JESSICA GRAVES MA, LPC, BCB

Provider Business Mailing Address
First Line	:	2727 BRYANT ST STE 510
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80211-4153
Country	:	US
Telephone Number	:	720-739-1711
Fax Number	:	720-739-1712

Provider Business Practice Location Address
First Line	:	2727 BRYANT ST STE 510
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80211-4153
Country	:	US
Telephone Number	:	720-739-1711
Fax Number	:	720-739-1712

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

Provider Enumeration Date	:	04/20/2006
Last Update Date	:	08/20/2024

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