Basic Information
Provider Information
NPI: 1841748282
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LORD
FirstName: ALEXA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: LORD MCCORMICK
OtherFirstName: ALEXA
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: LPC
OtherLastNameType: 1
Mailing Information
Address1: 155 INVERNESS DR W
Address2: SUITE 200
City: ENGLEWOOD
State: CO
PostalCode: 801125095
CountryCode: US
TelephoneNumber: 3037308858
FaxNumber: 3038890838
Practice Location
Address1: 6509 S SANTA FE DR
Address2:  
City: LITTLETON
State: CO
PostalCode: 801202910
CountryCode: US
TelephoneNumber: 3037308858
FaxNumber: 3038890838
Other Information
ProviderEnumerationDate: 09/14/2016
LastUpdateDate: 09/14/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500XLPC.0006028COY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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