Provider Demographics
NPI:1730372855
Name:CASIAS, DANIEL L (PHD, LMFT)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:L
Last Name:CASIAS
Suffix:
Gender:M
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 306
Mailing Address - Street 2:
Mailing Address - City:BAYFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:81122-0306
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:108 N BEHREND AVE
Practice Address - Street 2:SUITE G
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-8448
Practice Address - Country:US
Practice Address - Phone:505-326-2736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0614106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM0614OtherSTATE OF NEW MEXICO R&L