Provider Demographics
NPI:1316154677
Name:WOODS, DANIELLE THOMAS (LPC)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:THOMAS
Last Name:WOODS
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:HC 1 BOX 1406
Mailing Address - Street 2:
Mailing Address - City:STRAWBERRY
Mailing Address - State:AZ
Mailing Address - Zip Code:85544-9736
Mailing Address - Country:US
Mailing Address - Phone:928-476-3681
Mailing Address - Fax:
Practice Address - Street 1:700 W MAIN ST
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:AZ
Practice Address - Zip Code:85541-4790
Practice Address - Country:US
Practice Address - Phone:928-474-3311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC11362101YA0400X
AZLPC11835101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)