Provider Demographics
NPI:1588727242
Name:WINDAHAVEN, DANNY GARNER (LISAC)
Entity type:Individual
Prefix:
First Name:DANNY
Middle Name:GARNER
Last Name:WINDAHAVEN
Suffix:
Gender:M
Credentials:LISAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1036 S MARIANA ST
Mailing Address - Street 2:#1
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-4171
Mailing Address - Country:US
Mailing Address - Phone:480-894-6749
Mailing Address - Fax:
Practice Address - Street 1:1036 S MARIANA ST
Practice Address - Street 2:#1
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-4171
Practice Address - Country:US
Practice Address - Phone:480-894-6749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)