Individual provider Active NPI

Leslie NMN Jordan, PH.D.

  • Psychologist
  • Denver, CO
National Provider Identifier
1619792777
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
405 Issued in CO
Practice address
3955 East Exposition Ave.
Suite 405
Denver, CO 80209
Phone
(303) 778-6500
Fax
(303) 517-7802
NPI assigned
Nov 22, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 405 CO Primary

Addresses

Primary practice location

3955 East Exposition Ave.
Suite 405
Denver, CO 80209

Mailing address

3955 East Exposition Ave.
Suite 405
Denver, CO 80209
Phone (303) 778-6500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
405COMDAcupuncturist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1732233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1619792777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3955 EAST EXPOSITION AVE.",
            "address_2": "SUITE 405",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80209",
            "telephone_number": "303-778-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3955 EAST EXPOSITION AVE.",
            "address_2": "SUITE 405",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80209",
            "telephone_number": "303-778-6500",
            "fax_number": "303-517-7802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "LESLIE",
        "middle_name": "NMN",
        "name_prefix": "Ms.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-22",
        "last_updated": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.