Provider Demographics
NPI:1912605452
Name:BICKERT, DANIELLE (MA, NCC)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:BICKERT
Suffix:
Gender:F
Credentials:MA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 E. VINE STREET
Mailing Address - Street 2:
Mailing Address - City:STOWE
Mailing Address - State:PA
Mailing Address - Zip Code:19464
Mailing Address - Country:US
Mailing Address - Phone:484-300-9211
Mailing Address - Fax:
Practice Address - Street 1:649 N. LEWIS RD
Practice Address - Street 2:100-6
Practice Address - City:LIMERICK
Practice Address - State:PA
Practice Address - Zip Code:19468
Practice Address - Country:US
Practice Address - Phone:484-928-0568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-22
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
PAPC017184101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health