Individual
JACOB BERGSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
55 MADISON ST STE 240, DENVER, CO 80206-5451
(970) 310-3406
Mailing address
1234 N CLARKSON ST APT 303, DENVER, CO 80218-1853
(714) 797-0798
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
ACA.0008282
CO
101YM0800X
Mental Health Counselor
LPCC.0023748
CO
101YP2500X
Professional Counselor
Primary
LPCC.0023748
CO
Other
Enumeration date
08/15/2025
Last updated
08/28/2025
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