Provider Demographics
NPI:1770678088
Name:CUNNINGHAM, LESLEY S (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:LESLEY
Middle Name:S
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:MRS
Other - First Name:LESLEY
Other - Middle Name:S
Other - Last Name:HOUSSIERE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPC
Mailing Address - Street 1:1779 MACCULLEN DR
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:CO
Mailing Address - Zip Code:80516
Mailing Address - Country:US
Mailing Address - Phone:303-245-4430
Mailing Address - Fax:303-245-4459
Practice Address - Street 1:529 COFFMAN STE 300
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501
Practice Address - Country:US
Practice Address - Phone:303-245-4430
Practice Address - Fax:303-245-4459
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1049101YM0800X
CO68971101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health