Provider Demographics
NPI:1316337249
Name:RICHARDS, DANIELLE LYN (LCPC)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:LYN
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:LYN
Other - Last Name:ALTHOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC
Mailing Address - Street 1:PO BOX 991
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MT
Mailing Address - Zip Code:59044-0991
Mailing Address - Country:US
Mailing Address - Phone:406-530-5751
Mailing Address - Fax:
Practice Address - Street 1:13 1/2 COLORADO AVE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MT
Practice Address - Zip Code:59044-3151
Practice Address - Country:US
Practice Address - Phone:406-530-5751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-30
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-8348101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT81-0262019OtherYBGR