Provider Demographics
NPI:1114225422
Name:FIELDS, DANIELLE MONIQUE (LPC)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:MONIQUE
Last Name:FIELDS
Suffix:
Gender:F
Credentials:LPC
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 157
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:OK
Mailing Address - Zip Code:73007-0157
Mailing Address - Country:US
Mailing Address - Phone:405-326-4296
Mailing Address - Fax:
Practice Address - Street 1:628 NE 4TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-6256
Practice Address - Country:US
Practice Address - Phone:405-232-1401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-10
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3072261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)