Provider Demographics
NPI:1063877827
Name:BRANCHE, DANIELLE (MFT, LGMFT)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:BRANCHE
Suffix:
Gender:F
Credentials:MFT, LGMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 W MADISON ST
Mailing Address - Street 2:#11
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-5239
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10 W MADISON ST
Practice Address - Street 2:#11
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-5239
Practice Address - Country:US
Practice Address - Phone:443-438-7863
Practice Address - Fax:443-957-9485
Is Sole Proprietor?:No
Enumeration Date:2015-12-22
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGM522103TC0700X
MDLCM632106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical