Healthcare Provider Details

I. General information

NPI: 1811817653
Provider Name (Legal Business Name): DANIEL GLEASON LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3660 WADSWORTH BLVD
WHEAT RIDGE CO
80033-4609
US

IV. Provider business mailing address

2510 W 23RD AVE APT 1-301
DENVER CO
80211-4841
US

V. Phone/Fax

Practice location:
  • Phone: 720-526-2622
  • Fax:
Mailing address:
  • Phone: 203-644-4639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC.0024698
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: