Provider Demographics
NPI:1881837656
Name:POGREW- TERRANCE, LESLY JOY (MA LPC)
Entity Type:Individual
Prefix:
First Name:LESLY
Middle Name:JOY
Last Name:POGREW- TERRANCE
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1633 FILLMORE ST STE 406
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-1545
Mailing Address - Country:US
Mailing Address - Phone:303-733-1176
Mailing Address - Fax:
Practice Address - Street 1:1633 FILLMORE ST STE 406
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-1545
Practice Address - Country:US
Practice Address - Phone:303-733-1176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-09
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2231101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health