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General NPI Number Information
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NPI Number | 1881385631
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Entity Type | Organization
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Legal Business Name | CENTRAL COLORADO COUNSELING
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Dates
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Enumeration Date | 05/15/2023
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Last Update Date | 05/15/2023
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Provider Practice Location Address
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Address Line | 700 VALLEY VIEW DR
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City | WOODLAND PARK
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State | CO
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Zip | 80863-8370
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Country | US
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Telephone | 719-290-4393
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Fax | 719-960-2702
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Provider Business Mailing Address
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Address Line | 700 VALLEY VIEW DR
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City | WOODLAND PARK
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State | CO
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Zip | 80863-8370
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Country | US
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Telephone | 719-290-4393
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Fax | 719-960-2702
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Authorized Official
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Title or Position | OWNER
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Name | DANIEL J. LEBSACK
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Credential | LPC
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Telephone | 719-290-4393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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