Provider Demographics
NPI:1740553213
Name:MULLINAX, LEANNE L (LCSW)
Entity type:Individual
Prefix:
First Name:LEANNE
Middle Name:L
Last Name:MULLINAX
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LEANNE
Other - Middle Name:M
Other - Last Name:JIMENEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18500 E 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-9504
Mailing Address - Country:US
Mailing Address - Phone:720-847-6451
Mailing Address - Fax:
Practice Address - Street 1:18230 EAST SILVER CREEK STREET
Practice Address - Street 2:BLDG 392, MDG SOUTH
Practice Address - City:BUCKLEY AFB
Practice Address - State:CO
Practice Address - Zip Code:80011-9421
Practice Address - Country:US
Practice Address - Phone:720-847-6451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-14
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9920664104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker