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Individual

JEANNE MARIE WICKHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC, LAC

Contact information

Practice address
3225 TEMPLETON GAP RD STE 111, COLORADO SPRINGS, CO 80907-8729
(719) 351-9656
Mailing address
3225 TEMPLETON GAP RD STE 111, COLORADO SPRINGS, CO 80907-8729
(719) 351-9656

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
ACD.0001464
CO
101YM0800X
Mental Health Counselor
Primary
LPC.0017285
CO

Other

Enumeration date
01/19/2018
Last updated
03/17/2025
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