Active NPI
Stacey Handler Jessen, MA CCC SLP
- Speech-Language Pathologist
- Commerce City, CO
National Provider Identifier
1174361109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 24462328
- Practice address
- 5291 E 60TH Ave
Commerce City, CO 80022-3203 - Phone
- (303) 853-3264
- NPI assigned
- Jul 15, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 24462328 | CO | Primary |
Addresses
Primary practice location
5291 E 60TH Ave
Commerce City, CO 80022-3203
Mailing address
9067 W 101St Ave
Broomfield, CO 80021-3870
Phone (303) 907-9364
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24462328 | CO | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721001600000",
"number": "1174361109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9067 W 101ST AVE",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800213870",
"telephone_number": "303-907-9364"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5291 E 60TH AVE",
"city": "COMMERCE CITY",
"state": "CO",
"postal_code": "800223203",
"telephone_number": "303-853-3264"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JESSEN",
"first_name": "STACEY",
"middle_name": "HANDLER",
"name_prefix": "Mrs.",
"credential": "MA CCC SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-07-15",
"last_updated": "2024-07-15",
"certification_date": "2024-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CO",
"license": "24462328",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Commerce City, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.