Provider Demographics
NPI:1811058027
Name:LUNDY, DANIEL J (LPC)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:J
Last Name:LUNDY
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:P.O. BOX 2135
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80901-2135
Mailing Address - Country:US
Mailing Address - Phone:719-271-6677
Mailing Address - Fax:
Practice Address - Street 1:2021 W COLORADO AVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80904-3840
Practice Address - Country:US
Practice Address - Phone:719-271-6677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1606101YM0800X
COLPC.0001606101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000142369Medicaid
CO164712Medicaid