Provider Demographics
NPI:1083763148
Name:HUERTA, DANIEL PAUL (MSW, LCSW)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:PAUL
Last Name:HUERTA
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:6165 LEHMAN DR
Mailing Address - Street 2:SUITE # 106
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-3441
Mailing Address - Country:US
Mailing Address - Phone:719-339-9982
Mailing Address - Fax:719-266-0447
Practice Address - Street 1:6165 LEHMAN DR
Practice Address - Street 2:SUITE # 106
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-3441
Practice Address - Country:US
Practice Address - Phone:719-339-9982
Practice Address - Fax:719-266-0447
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO9930381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO532732OtherVALUE OPTIONS
CO532732OtherCOLORADO HEALTH NETWORKS