Provider Demographics
NPI:1972244259
Name:EDMONDSON, DANIEL KIRK (LMHC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:KIRK
Last Name:EDMONDSON
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6953 AVALON CIR UNIT 1808
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34112-7375
Mailing Address - Country:US
Mailing Address - Phone:206-375-4928
Mailing Address - Fax:
Practice Address - Street 1:1044 CASTELLO DR STE 210
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-1900
Practice Address - Country:US
Practice Address - Phone:239-398-4882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-02
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH23132101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health