Provider Demographics
NPI:1528842895
Name:BURANDT, DARCELLE DENISE (LPC)
Entity type:Individual
Prefix:
First Name:DARCELLE
Middle Name:DENISE
Last Name:BURANDT
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 1:6095 COLLOPY PL
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32163-5938
Mailing Address - Country:US
Mailing Address - Phone:352-843-4033
Mailing Address - Fax:
Practice Address - Street 1:6095 COLLOPY PL
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32163-5938
Practice Address - Country:US
Practice Address - Phone:352-843-4033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-18
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC009431101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health