Provider Demographics
NPI:1326213745
Name:TREANOR, LEA (PSYD, NCSP, LPC)
Entity Type:Individual
Prefix:
First Name:LEA
Middle Name:
Last Name:TREANOR
Suffix:
Gender:F
Credentials:PSYD, NCSP, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 562
Mailing Address - Street 2:
Mailing Address - City:OAK CREEK
Mailing Address - State:CO
Mailing Address - Zip Code:80467-0562
Mailing Address - Country:US
Mailing Address - Phone:970-846-3266
Mailing Address - Fax:
Practice Address - Street 1:1475 PINE GROVE RD
Practice Address - Street 2:SUITE 206
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487-8803
Practice Address - Country:US
Practice Address - Phone:970-846-3266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-26
Last Update Date:2008-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1583101YP2500X
103T00000X
CO31254103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent