Provider Demographics
NPI:1538422563
Name:LEFFORGE, NOELLE L (PHD)
Entity type:Individual
Prefix:DR
First Name:NOELLE
Middle Name:L
Last Name:LEFFORGE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 S VINE ST
Mailing Address - Street 2:RM 43
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5264
Mailing Address - Country:US
Mailing Address - Phone:702-757-8601
Mailing Address - Fax:
Practice Address - Street 1:2450 S VINE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5264
Practice Address - Country:US
Practice Address - Phone:702-757-8601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-25
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY.0005500103T00000X, 103TC0700X, 103TP2701X
NVPY0648103TC0700X, 103TP2701X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy