Provider Demographics
NPI:1992114904
Name:FLAHERTY, DANIEL
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:FLAHERTY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 WINTHROP AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02170-3327
Mailing Address - Country:US
Mailing Address - Phone:617-777-2039
Mailing Address - Fax:
Practice Address - Street 1:127 CRANBERRY RD
Practice Address - Street 2:
Practice Address - City:WHITMAN
Practice Address - State:MA
Practice Address - Zip Code:02382-1614
Practice Address - Country:US
Practice Address - Phone:617-777-2039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-05
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No171M00000XOther Service ProvidersCase Manager/Care Coordinator