Provider Demographics
NPI:1043309248
Name:GONZALEZ, LEE ALLYS (MA)
Entity Type:Individual
Prefix:MRS
First Name:LEE
Middle Name:ALLYS
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MRS
Other - First Name:LEE
Other - Middle Name:ALLYS
Other - Last Name:CULBERTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT, LPC, LAC
Mailing Address - Street 1:10350 E DAKOTA AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-1314
Mailing Address - Country:US
Mailing Address - Phone:303-338-4545
Mailing Address - Fax:
Practice Address - Street 1:8383 W ALAMEDA AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-3007
Practice Address - Country:US
Practice Address - Phone:303-338-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMFT.0000976106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist