Provider Demographics
NPI:1730710054
Name:ALLEN, JESSICA (PHD, LP, BCBA)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:PHD, LP, BCBA
Other - Prefix:DR
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:PEARSON-ALLEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, LP, BCBA
Mailing Address - Street 1:2912 BEACON ST STE 110
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-9207
Mailing Address - Country:US
Mailing Address - Phone:214-701-0158
Mailing Address - Fax:
Practice Address - Street 1:2912 BEACON ST STE 110
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-9207
Practice Address - Country:US
Practice Address - Phone:719-377-8030
Practice Address - Fax:855-876-2030
Is Sole Proprietor?:No
Enumeration Date:2020-01-27
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6219103G00000X, 103TC1900X, 103TC2200X, 103TH0100X, 103TS0200X, 103TC0700X
TX1327103K00000X
TX39861103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1497142079OtherNPI