Provider Demographics
NPI:1942226683
Name:ROGERS, LESLIE M (MA, LPC, NBC)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:M
Last Name:ROGERS
Suffix:
Gender:F
Credentials:MA, LPC, NBC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 552
Mailing Address - Street 2:
Mailing Address - City:FRANKTOWN
Mailing Address - State:CO
Mailing Address - Zip Code:80116-0552
Mailing Address - Country:US
Mailing Address - Phone:303-814-5411
Mailing Address - Fax:
Practice Address - Street 1:1189 S PERRY ST
Practice Address - Street 2:SUITE 110C
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-1958
Practice Address - Country:US
Practice Address - Phone:303-814-5411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2507103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling