Provider Demographics
NPI:1346774346
Name:LEDER, LOIS (LCSW)
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:
Last Name:LEDER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 S. ONEIDA ST. #412
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224
Mailing Address - Country:US
Mailing Address - Phone:303-378-8642
Mailing Address - Fax:
Practice Address - Street 1:2121 S. ONEIDA ST. #412
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224
Practice Address - Country:US
Practice Address - Phone:303-378-8642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-17
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO980031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical