Provider Demographics
NPI:1720223548
Name:DANIEL, DALE E (LPC, CAC III)
Entity Type:Individual
Prefix:MR
First Name:DALE
Middle Name:E
Last Name:DANIEL
Suffix:
Gender:M
Credentials:LPC, CAC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6365 SEASIDE DR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-7055
Mailing Address - Country:US
Mailing Address - Phone:970-449-9654
Mailing Address - Fax:419-793-1879
Practice Address - Street 1:1006 ROBERTSON ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3900
Practice Address - Country:US
Practice Address - Phone:970-482-3820
Practice Address - Fax:970-482-4942
Is Sole Proprietor?:No
Enumeration Date:2008-12-08
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1655101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional