Provider Demographics
NPI:1922586908
Name:LEBSACK, DANIEL J (LPC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:J
Last Name:LEBSACK
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:WOODLAND PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80863-8823
Mailing Address - Country:US
Mailing Address - Phone:972-834-0604
Mailing Address - Fax:
Practice Address - Street 1:700 VALLEY VIEW DR UNIT D
Practice Address - Street 2:
Practice Address - City:WOODLAND PARK
Practice Address - State:CO
Practice Address - Zip Code:80863-8000
Practice Address - Country:US
Practice Address - Phone:719-290-4393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-01
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX76462101YP2500X
CO14643101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional