Provider Demographics
NPI:1487028817
Name:HECHT, LESLEE SUSAN
Entity Type:Individual
Prefix:
First Name:LESLEE
Middle Name:SUSAN
Last Name:HECHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2594 TRAILRIDGE DR E
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-3186
Mailing Address - Country:US
Mailing Address - Phone:303-442-0961
Mailing Address - Fax:
Practice Address - Street 1:2593 PARK LN
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-3172
Practice Address - Country:US
Practice Address - Phone:303-926-4744
Practice Address - Fax:303-415-3451
Is Sole Proprietor?:No
Enumeration Date:2015-11-23
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.000015171041C0700X
MD085191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1083073050OtherNPI