Provider Demographics
NPI:1508110735
Name:STURTZ, EUGENE DANIEL (MA, CAS, LADAC)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:DANIEL
Last Name:STURTZ
Suffix:
Gender:M
Credentials:MA, CAS, LADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 WHITE AVE
Mailing Address - Street 2:
Mailing Address - City:AZTEC
Mailing Address - State:NM
Mailing Address - Zip Code:87410-2338
Mailing Address - Country:US
Mailing Address - Phone:970-779-8457
Mailing Address - Fax:
Practice Address - Street 1:1911 MAIN AVE STE 206
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-5077
Practice Address - Country:US
Practice Address - Phone:970-779-4857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-09
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1809101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)