Provider Demographics
NPI:1063761401
Name:BLUMENTHAL, DANIEL K (MS, LGPC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:K
Last Name:BLUMENTHAL
Suffix:
Gender:M
Credentials:MS, LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 S MAIN ST BLDG A
Mailing Address - Street 2:SUITE 105
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-5447
Mailing Address - Country:US
Mailing Address - Phone:410-852-2835
Mailing Address - Fax:
Practice Address - Street 1:900 S MAIN ST BLDG A
Practice Address - Street 2:SUITE 105
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-5447
Practice Address - Country:US
Practice Address - Phone:410-852-2835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-30
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health