Provider Demographics
NPI:1588450993
Name:DESSASO, DANIELLE MAYA (LPC)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:MAYA
Last Name:DESSASO
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4202 LAVENDER LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4285
Mailing Address - Country:US
Mailing Address - Phone:757-344-9521
Mailing Address - Fax:
Practice Address - Street 1:4202 LAVENDER LN
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-4285
Practice Address - Country:US
Practice Address - Phone:757-344-9521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701012460101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional