Provider Demographics
NPI:1891292967
Name:NUNN, DANISHA L (LCDC-I)
Entity type:Individual
Prefix:
First Name:DANISHA
Middle Name:L
Last Name:NUNN
Suffix:
Gender:F
Credentials:LCDC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2029 DAYTON ST APT 146
Mailing Address - Street 2:
Mailing Address - City:HALTOM CITY
Mailing Address - State:TX
Mailing Address - Zip Code:76117-5126
Mailing Address - Country:US
Mailing Address - Phone:682-235-0616
Mailing Address - Fax:
Practice Address - Street 1:2340 E TRINITY MILLS RD STE 300
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-1947
Practice Address - Country:US
Practice Address - Phone:469-608-0295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-06
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374J00000X
TX69437101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No374J00000XNursing Service Related ProvidersDoula