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General NPI Number Information
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NPI Number | 1063415560
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Entity Type | Individual
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Provider Name | LUCINDA TACHA LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/27/2005
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Last Update Date | 04/04/2022
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Provider Practice Location Address
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Address Line | 820 1ST ST.
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City | LIMON
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State | CO
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Zip | 80828-1120
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Country | US
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Telephone | 719-775-2367
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Fax | 719-775-2365
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Provider Business Mailing Address
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Address Line | 111 6TH ST
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City | HUGO
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State | CO
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Zip | 80821-2002
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Country | US
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Telephone | 719-632-5700
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Fax | 719-344-7817
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 992478
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License Number State | CO
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