Provider Demographics
NPI:1104103993
Name:ACKROYD, DANIEL (BCPMHNP)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:
Last Name:ACKROYD
Suffix:
Gender:M
Credentials:BCPMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 WALLACE ST
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-6425
Mailing Address - Country:US
Mailing Address - Phone:617-318-8557
Mailing Address - Fax:978-237-5849
Practice Address - Street 1:5 WALLACE ST
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-6425
Practice Address - Country:US
Practice Address - Phone:617-318-8557
Practice Address - Fax:978-237-5249
Is Sole Proprietor?:No
Enumeration Date:2011-11-08
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA266962363LP0808X, 364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult