Provider Demographics
NPI:1558798249
Name:QUEEN, LEAH (LMFT)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:QUEEN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4141 E DICKENSON PL
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-6012
Mailing Address - Country:US
Mailing Address - Phone:303-504-6500
Mailing Address - Fax:303-504-6908
Practice Address - Street 1:1440 GROVE ST UNIT A
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-2201
Practice Address - Country:US
Practice Address - Phone:303-504-7900
Practice Address - Fax:303-504-6908
Is Sole Proprietor?:No
Enumeration Date:2013-09-26
Last Update Date:2015-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMFT.0000946106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist