Provider Demographics
NPI:1396564456
Name:LEBOWITZ, DANIEL (LMFT)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:LEBOWITZ
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:264 LEWIS LN
Mailing Address - Street 2:
Mailing Address - City:BASALT
Mailing Address - State:CO
Mailing Address - Zip Code:81621-9394
Mailing Address - Country:US
Mailing Address - Phone:720-443-0939
Mailing Address - Fax:
Practice Address - Street 1:264 LEWIS LN
Practice Address - Street 2:
Practice Address - City:BASALT
Practice Address - State:CO
Practice Address - Zip Code:81621-9394
Practice Address - Country:US
Practice Address - Phone:720-443-0939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1422106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist