=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699038844
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOHN DAVID LOBUE JR. LPC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/22/2012
-----------------------------------------------------
Last Update Date | 11/01/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 983 BRAMBLEWOOD DR
-----------------------------------------------------
City | CASTLE PINES
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80108-3642
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-378-5552
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 964 SPRUCE CT
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80230-7108
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-780-5040
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | LPC.0020419
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------