Provider Demographics
NPI:1760719959
Name:LEROUX, SUSAN (LPC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:LEROUX
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:LEROUX
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4875 DTC BLVD STE 10-101
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3317
Mailing Address - Country:US
Mailing Address - Phone:303-362-9991
Mailing Address - Fax:
Practice Address - Street 1:2600 S PARKER RD
Practice Address - Street 2:STE 242A
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1613
Practice Address - Country:US
Practice Address - Phone:720-629-5269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-09
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4242101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional