Provider Demographics
NPI:1285062547
Name:DASH, DANIELLE (LPCMH)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:DASH
Suffix:
Gender:F
Credentials:LPCMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 MONT BLANC BLVD
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-7615
Mailing Address - Country:US
Mailing Address - Phone:302-678-2030
Mailing Address - Fax:302-678-2458
Practice Address - Street 1:103 MONT BLANC BLVD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-7615
Practice Address - Country:US
Practice Address - Phone:302-678-2030
Practice Address - Fax:302-678-2458
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-24
Last Update Date:2013-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0000648101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional