Provider Demographics
NPI:1932245800
Name:DEAL, DANIEL D (MA CCDC III, SAP)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:D
Last Name:DEAL
Suffix:
Gender:M
Credentials:MA CCDC III, SAP
Other - Prefix:MR
Other - First Name:DAN
Other - Middle Name:D
Other - Last Name:DEAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA CCDC III SAP
Mailing Address - Street 1:2210 S BROWN PL
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-6582
Mailing Address - Country:US
Mailing Address - Phone:605-336-1974
Mailing Address - Fax:605-336-9031
Practice Address - Street 1:2110 S. BROWN PLACE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-6582
Practice Address - Country:US
Practice Address - Phone:605-336-1974
Practice Address - Fax:605-336-9031
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD9607747101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)