Provider Demographics
NPI:1033540414
Name:KISLER, DANIELLE NICHOLE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:NICHOLE
Last Name:KISLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7905 N MEADOWLARK WAY
Mailing Address - Street 2:STE A AND B
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83815-5041
Mailing Address - Country:US
Mailing Address - Phone:208-691-2048
Mailing Address - Fax:
Practice Address - Street 1:7905 N MEADOWLARK WAY
Practice Address - Street 2:STE A AND B
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83815-5041
Practice Address - Country:US
Practice Address - Phone:208-691-2048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-10
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-5160101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional