Provider Demographics
NPI:1396313821
Name:STREICH, DANIELLE J (LPC)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:J
Last Name:STREICH
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 1:65 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:BROWNS MILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:08015-4317
Mailing Address - Country:US
Mailing Address - Phone:732-567-4739
Mailing Address - Fax:
Practice Address - Street 1:1124 US HIGHWAY 202 STE B10
Practice Address - Street 2:
Practice Address - City:RARITAN
Practice Address - State:NJ
Practice Address - Zip Code:08869-1463
Practice Address - Country:US
Practice Address - Phone:908-332-9317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-11
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00774800101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ37PC00774800OtherLPC LICENSE NUMBER