Jessica Leah Evers Killebrew, PSY.D.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2503 Walnut St Ste 201
Boulder, CO 80302-5745

Phone

(858) 353-8083

NPI assigned

Mar 27, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Jessica Leah Evers Killebrew Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1346368396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 ROOSEVELT AVE APT B",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800272172",
            "telephone_number": "858-353-8083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2503 WALNUT ST STE 201",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803025745",
            "telephone_number": "858-353-8083"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Sportfisher Dr",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "CA",
            "postal_code": "920542550",
            "country_code": "US",
            "telephone_number": "760-439-6702 x215",
            "fax_number": "760-439-4779",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVERS KILLEBREW",
        "first_name": "JESSICA",
        "middle_name": "LEAH",
        "name_prefix": "Ms.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "KILLEBREW",
            "middle_name": "LEAH EVERS",
            "credential": "PSY.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Rachal Nicole Everhart, M.S., CCC-SLP
• Dorian Evers, M.ED.
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• Mary E Ewers-Dennison, OTR, CHT

• Mental Health Counselor in Boulder, CO
• Providers in Boulder, CO by specialty
• Mental Health Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.