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NPI Code Detail

MEDICARE: JESSICA S KIRCHBERG LCPC (IL), LPC (CO)

MEDICARE: JESSICA S KIRCHBERG LCPC (IL), LPC (CO)
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
1101YP2500XProfessional Counselor0017642CO
2101YP2500XProfessional Counselor180.013805IL

General Provider Information

NPI Number : 1851808240
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA S KIRCHBERG LCPC (IL), LPC (CO)
Provider Business Mailing Address
First Line : 5618 YARROW ST
Second Line :
City : ARVADA
State : CO
Zip : 80002-2442
Country : US
Telephone Number : 224-377-0390
Fax Number :
Provider Business Practice Location Address
First Line : 2950 W CHICAGO AVE STE 202
Second Line :
City : CHICAGO
State : IL
Zip : 60622-4377
Country : US
Telephone Number : 224-377-0390
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2018
Last Update Date : 03/29/2023

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