Provider Demographics
NPI:1538775804
Name:BLAKEMAN, DANIEL PATRICK (LMHC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:PATRICK
Last Name:BLAKEMAN
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2220 SW 34TH ST APT 326
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-1213
Mailing Address - Country:US
Mailing Address - Phone:330-301-0973
Mailing Address - Fax:
Practice Address - Street 1:2220 SW 34TH ST APT 326
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-1213
Practice Address - Country:US
Practice Address - Phone:330-301-0973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH18367101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health