Provider Demographics
NPI:1972326973
Name:DK COUNSELING AND CLINICAL SUPERVISION, LLC
Entity type:Organization
Organization Name:DK COUNSELING AND CLINICAL SUPERVISION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KAPELLE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:602-613-0403
Mailing Address - Street 1:17421 N 85TH DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-8026
Mailing Address - Country:US
Mailing Address - Phone:602-613-0403
Mailing Address - Fax:
Practice Address - Street 1:8765 W KELTON LN BLDG B3
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-3584
Practice Address - Country:US
Practice Address - Phone:602-613-0403
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health