Basic Information
| Provider Information | |||||||||
| NPI: | 1215685607 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEDESMA | ||||||||
| FirstName: | ELIZABETH | ||||||||
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| Credential: | MA, LPCC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1975 MILE HIGH STADIUM CIR APT 1004 | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802041751 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7203940260 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6255 QUEBEC PKWY | ||||||||
| Address2: | |||||||||
| City: | COMMERCE CITY | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800224812 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3036972583 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2022 | ||||||||
| LastUpdateDate: | 03/14/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | LPCC.0019013 | CO | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.