Provider Demographics
NPI:1962807032
Name:LECHLEITER, DANIEL (MA, LPC, ACS)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:LECHLEITER
Suffix:
Gender:M
Credentials:MA, LPC, ACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 38TH AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-2579
Mailing Address - Country:US
Mailing Address - Phone:720-598-2792
Mailing Address - Fax:
Practice Address - Street 1:1120 38TH AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-2578
Practice Address - Country:US
Practice Address - Phone:720-598-2792
Practice Address - Fax:877-348-8693
Is Sole Proprietor?:No
Enumeration Date:2014-10-30
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
COLPC.013273101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1962807032Medicaid