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General NPI Number Information
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NPI Number | 1922586908
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Entity Type | Individual
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Provider Name | DANIEL J LEBSACK LPC
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Gender | Male
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Dates
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Enumeration Date | 08/01/2018
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Last Update Date | 09/17/2018
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Provider Practice Location Address
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Address Line | 700 VALLEY VIEW DR UNIT D
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City | WOODLAND PARK
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State | CO
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Zip | 80863-8000
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Country | US
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Telephone | 719-290-4393
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Fax |
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Provider Business Mailing Address
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Address Line | 211 PENNSYLVANIA AVE
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City | WOODLAND PARK
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State | CO
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Zip | 80863-8823
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Country | US
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Telephone | 972-834-0604
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 76462
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 14643
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License Number State | CO
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