Provider Demographics
NPI:1477897882
Name:DICKSON, DANIELLE L (MA, LPC)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:L
Last Name:DICKSON
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:SOLANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPC
Mailing Address - Street 1:824 GREEN WOOD DR
Mailing Address - Street 2:
Mailing Address - City:BERTHOUD
Mailing Address - State:CO
Mailing Address - Zip Code:80513-1442
Mailing Address - Country:US
Mailing Address - Phone:720-301-9449
Mailing Address - Fax:
Practice Address - Street 1:1455 DIXON AVE
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-8879
Practice Address - Country:US
Practice Address - Phone:303-443-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-26
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0014022101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional