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General NPI Number Information
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NPI Number | 1265163869
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Entity Type | Individual
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Provider Name | DANIEL GIFFORD HERTEL LAC, LCSW
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Gender | Male
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Dates
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Enumeration Date | 06/23/2022
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Last Update Date | 05/15/2024
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Provider Practice Location Address
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Address Line | 6655 W JEWELL AVE STE 205
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City | LAKEWOOD
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State | CO
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Zip | 80232-7108
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Country | US
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Telephone | 720-354-0047
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Fax |
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Provider Business Mailing Address
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Address Line | 3580 W ARIZONA AVE
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City | DENVER
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State | CO
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Zip | 80219-3905
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Country | US
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Telephone | 720-354-0047
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Fax |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | ACD.0002101
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW.09930443
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License Number State | CO
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