Provider Demographics
NPI:1104649383
Name:COLEMAN, ALEXIS LEEANNE (LCSW)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:LEEANNE
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4228 KALAMATH ST UNIT 336
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-3091
Mailing Address - Country:US
Mailing Address - Phone:906-241-8106
Mailing Address - Fax:
Practice Address - Street 1:4228 KALAMATH ST UNIT 336
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-3091
Practice Address - Country:US
Practice Address - Phone:906-241-8106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO099309391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical