Provider Demographics
NPI:1245922699
Name:LE BON, LEXIS ANN
Entity type:Individual
Prefix:
First Name:LEXIS
Middle Name:ANN
Last Name:LE BON
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 1:575 RANCHHAND DR
Mailing Address - Street 2:
Mailing Address - City:BERTHOUD
Mailing Address - State:CO
Mailing Address - Zip Code:80513-2700
Mailing Address - Country:US
Mailing Address - Phone:720-226-4644
Mailing Address - Fax:
Practice Address - Street 1:575 RANCHHAND DR
Practice Address - Street 2:
Practice Address - City:BERTHOUD
Practice Address - State:CO
Practice Address - Zip Code:80513-2700
Practice Address - Country:US
Practice Address - Phone:720-226-4644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty