Provider Demographics
NPI:1588132922
Name:MCDANIEL, SHEREE MARIE (LPC)
Entity type:Individual
Prefix:
First Name:SHEREE
Middle Name:MARIE
Last Name:MCDANIEL
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 1:1016 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-4247
Mailing Address - Country:US
Mailing Address - Phone:419-349-1789
Mailing Address - Fax:
Practice Address - Street 1:413 N GRAND ST STE A
Practice Address - Street 2:
Practice Address - City:SCHOOLCRAFT
Practice Address - State:MI
Practice Address - Zip Code:49087-9203
Practice Address - Country:US
Practice Address - Phone:269-409-3590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-03
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401017861101YP2500X
MI6401012509101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional