Provider Demographics
NPI:1790518744
Name:SPERRY, JESSE J
Entity type:Individual
Prefix:
First Name:JESSE
Middle Name:J
Last Name:SPERRY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7600 ACOMA CT
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80221-4101
Mailing Address - Country:US
Mailing Address - Phone:720-901-5868
Mailing Address - Fax:
Practice Address - Street 1:7600 ACOMA CT
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80221-4101
Practice Address - Country:US
Practice Address - Phone:720-901-5868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-24
Last Update Date:2024-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty