Provider Demographics
NPI:1699273920
Name:DANIELS, KIRAH ELIZABETH (LPCA)
Entity type:Individual
Prefix:MRS
First Name:KIRAH
Middle Name:ELIZABETH
Last Name:DANIELS
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:MISS
Other - First Name:KIRAH
Other - Middle Name:ELIZABETH
Other - Last Name:RAWLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1101 EXCHANGE PL APT 431
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-1888
Mailing Address - Country:US
Mailing Address - Phone:303-588-5014
Mailing Address - Fax:
Practice Address - Street 1:2670 DURHAM CHAPEL HILL BLVD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-2829
Practice Address - Country:US
Practice Address - Phone:919-251-9001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-01
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA13623101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional