Provider Demographics
NPI:1104385517
Name:RAULERSON, LEAH (LPC, NCC)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:RAULERSON
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3427 E 29TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-5034
Mailing Address - Country:US
Mailing Address - Phone:202-642-2494
Mailing Address - Fax:
Practice Address - Street 1:1720 SOUTH BELLAIRE STREET,
Practice Address - Street 2:SUITE 710
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222
Practice Address - Country:US
Practice Address - Phone:720-232-0834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-15
Last Update Date:2024-09-26
Deactivation Date:2020-06-25
Deactivation Code:
Reactivation Date:2024-09-11
Provider Licenses
StateLicense IDTaxonomies
CO0014918101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health