Provider Demographics
NPI:1922838374
Name:COLE, JAYCEE R (LPCC)
Entity type:Individual
Prefix:
First Name:JAYCEE
Middle Name:R
Last Name:COLE
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2629 JUNIPER AVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-2456
Mailing Address - Country:US
Mailing Address - Phone:989-388-1741
Mailing Address - Fax:
Practice Address - Street 1:2629 JUNIPER AVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-2456
Practice Address - Country:US
Practice Address - Phone:989-388-1741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-01
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0021746101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor