Provider Demographics
NPI:1992965446
Name:ROMBACH, DANIELLE (MA, LPC, NCC, CCDP)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:ROMBACH
Suffix:
Gender:F
Credentials:MA, LPC, NCC, CCDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:697 STATE AVE
Mailing Address - Street 2:
Mailing Address - City:VANPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15009-9502
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:697 STATE AVE
Practice Address - Street 2:
Practice Address - City:VANPORT
Practice Address - State:PA
Practice Address - Zip Code:15009-9502
Practice Address - Country:US
Practice Address - Phone:724-770-9820
Practice Address - Fax:724-728-2153
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004731101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional