Basic Information
Provider Information
NPI: 1790310423
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEHTO
FirstName: STEPHANIE
MiddleName: LYNN
NamePrefix:  
NameSuffix:  
Credential: PSYD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 17026 E OHIO DR APT 301
Address2:  
City: AURORA
State: CO
PostalCode: 800173337
CountryCode: US
TelephoneNumber: 9516627844
FaxNumber:  
Practice Location
Address1: 13001 E 17TH PL FL 2
Address2:  
City: AURORA
State: CO
PostalCode: 800452570
CountryCode: US
TelephoneNumber: 3037241000
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/03/2020
LastUpdateDate: 06/15/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/15/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103TC0700XPSY.0004931COY Behavioral Health & Social Service ProvidersPsychologistClinical

No ID Information.


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