Healthcare Provider Details

I. General information

NPI: 1023563814
Provider Name (Legal Business Name): ELSEY MCLEOD PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2016
Last Update Date: 08/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

673 N GRANT ST
DENVER CO
80203-3506
US

IV. Provider business mailing address

2019 S XENIA WAY
DENVER CO
80231-3360
US

V. Phone/Fax

Practice location:
  • Phone: 720-244-5162
  • Fax:
Mailing address:
  • Phone: 720-244-5162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1660
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number0213535
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: