Provider Demographics
NPI:1508127366
Name:THRUTCHLEY, DANNY JOE (LPC CACIII)
Entity Type:Individual
Prefix:MR
First Name:DANNY
Middle Name:JOE
Last Name:THRUTCHLEY
Suffix:
Gender:M
Credentials:LPC CACIII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21737 WCR 49
Mailing Address - Street 2:
Mailing Address - City:LASALLE
Mailing Address - State:CO
Mailing Address - Zip Code:80645
Mailing Address - Country:US
Mailing Address - Phone:970-590-4635
Mailing Address - Fax:970-366-4580
Practice Address - Street 1:1011 37TH AVENUE CT
Practice Address - Street 2:SUITE 201-D
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-2562
Practice Address - Country:US
Practice Address - Phone:970-590-4635
Practice Address - Fax:970-366-4580
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6049101YA0400X
CO3008101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)