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Individual

MRS. BRANDI LEIGH JACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, LAC, LPCC

Contact information

Practice address
1601 25TH AVE, GREELEY, CO 80634-4907
(970) 378-8805
Mailing address
1437 DENVER AVE # 325, LOVELAND, CO 80538-5226
(970) 378-8805

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACD.0002625
CO
101YM0800X
Mental Health Counselor
LPCC.0022539
CO

Other

Enumeration date
09/11/2015
Last updated
07/02/2025
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