Provider Demographics
NPI:1538759691
Name:AMY DANIELS LPC INC
Entity type:Organization
Organization Name:AMY DANIELS LPC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:HANES
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:251-366-1710
Mailing Address - Street 1:4833 AUDUBON DR
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36619-8960
Mailing Address - Country:US
Mailing Address - Phone:251-366-1710
Mailing Address - Fax:
Practice Address - Street 1:826 LAKESIDE DR STE D
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36693-5124
Practice Address - Country:US
Practice Address - Phone:251-366-1710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
1164634812OtherLICENSED PROFESSIONAL COUNSELOR