Provider Demographics
NPI:1013539360
Name:LEVANAS, DANIELLE (MA, LCAT, RDT)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:LEVANAS
Suffix:
Gender:F
Credentials:MA, LCAT, RDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 SILVER RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90039-3646
Mailing Address - Country:US
Mailing Address - Phone:646-271-4971
Mailing Address - Fax:
Practice Address - Street 1:2350 SILVER RIDGE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90039-3646
Practice Address - Country:US
Practice Address - Phone:646-271-4971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-09
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYLCAT002074101200000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101200000XBehavioral Health & Social Service ProvidersDrama Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYLCAT002074OtherLICENSED CREATIVE ARTS THERAPIST