Provider Demographics
NPI:1821053786
Name:LEWARK, LESLIE H (MA LPC CAC III C-AAM)
Entity Type:Individual
Prefix:MR
First Name:LESLIE
Middle Name:H
Last Name:LEWARK
Suffix:
Gender:M
Credentials:MA LPC CAC III C-AAM
Other - Prefix:
Other - First Name:LES
Other - Middle Name:H
Other - Last Name:LEWARK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA LPC CAC LLL C-AAM
Mailing Address - Street 1:PO BOX 100431
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80250
Mailing Address - Country:US
Mailing Address - Phone:303-832-5333
Mailing Address - Fax:303-832-5333
Practice Address - Street 1:750 E 9TH AVE
Practice Address - Street 2:STE 107
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203
Practice Address - Country:US
Practice Address - Phone:303-832-5333
Practice Address - Fax:303-832-5333
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2183101YA0400X
CO110101YM0800X
CO106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist