Provider Demographics
NPI:1154585610
Name:TAYLOR, DANEEN E (LCPC)
Entity type:Individual
Prefix:MRS
First Name:DANEEN
Middle Name:E
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24755 S RIVER TRL
Mailing Address - Street 2:
Mailing Address - City:CHANNAHON
Mailing Address - State:IL
Mailing Address - Zip Code:60410-8631
Mailing Address - Country:US
Mailing Address - Phone:815-546-5202
Mailing Address - Fax:
Practice Address - Street 1:13246 S RTE 59
Practice Address - Street 2:SUITE 100
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60585-9800
Practice Address - Country:US
Practice Address - Phone:815-546-5202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.006655101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional