Healthcare Provider Details

I. General information

NPI: 1750156915
Provider Name (Legal Business Name): JACK ENDRE HUFF LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2023
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

695 JERRY ST STE 205
CASTLE ROCK CO
80104-1708
US

IV. Provider business mailing address

695 JERRY ST STE 205
CASTLE ROCK CO
80104-1708
US

V. Phone/Fax

Practice location:
  • Phone: 720-729-7372
  • Fax:
Mailing address:
  • Phone: 720-729-7372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: