Provider Demographics
NPI:1255347092
Name:MOEN, DANIEL D (LCSW)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:D
Last Name:MOEN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 E PRENTICE AVE STE D12
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2759
Mailing Address - Country:US
Mailing Address - Phone:303-779-5335
Mailing Address - Fax:303-779-7982
Practice Address - Street 1:8000 E PRENTICE AVE STE D12
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2759
Practice Address - Country:US
Practice Address - Phone:303-779-5335
Practice Address - Fax:303-779-7982
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9860231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical