Provider Demographics
NPI:1780186270
Name:DEREMER, LEANNE MICHELLE
Entity Type:Individual
Prefix:
First Name:LEANNE
Middle Name:MICHELLE
Last Name:DEREMER
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 1:141 W DAVIES AVE N STE 105
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-4287
Mailing Address - Country:US
Mailing Address - Phone:303-730-1717
Mailing Address - Fax:
Practice Address - Street 1:141 W DAVIES AVE N STE 105
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-4287
Practice Address - Country:US
Practice Address - Phone:303-730-1717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-01
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0014385101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor