Provider Demographics
NPI:1801660089
Name:VANDERLEEST, HAILEY (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:HAILEY
Middle Name:
Last Name:VANDERLEEST
Suffix:
Gender:
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7596 W JEWELL AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80232-6889
Mailing Address - Country:US
Mailing Address - Phone:720-239-2514
Mailing Address - Fax:
Practice Address - Street 1:7596 W JEWELL AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80232-6889
Practice Address - Country:US
Practice Address - Phone:720-239-2514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-08
Last Update Date:2025-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023019766363LP0808X
COC-APN.0101398-C-NP363LP0808X
COAPN.0101398363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health