Provider Demographics
NPI:1265928014
Name:LEE, SUSAN A
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:A
Last Name:LEE
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 1:7951 E MAPLEWOOD AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4726
Mailing Address - Country:US
Mailing Address - Phone:303-930-7824
Mailing Address - Fax:303-267-4406
Practice Address - Street 1:7951 E MAPLEWOOD AVE STE 300
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-4726
Practice Address - Country:US
Practice Address - Phone:303-930-7824
Practice Address - Fax:303-267-4406
Is Sole Proprietor?:No
Enumeration Date:2018-07-05
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.009928181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical