Healthcare Provider Details

I. General information

NPI: 1619883592
Provider Name (Legal Business Name): JOYCE DIANE MCHUGH LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12603 LAKE VIEW ST
FIRESTONE CO
80504-5351
US

IV. Provider business mailing address

PO BOX 1058
LONGMONT CO
80502-1058
US

V. Phone/Fax

Practice location:
  • Phone: 720-435-7241
  • Fax:
Mailing address:
  • Phone: 720-435-7241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number09931310
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: