Provider Demographics
NPI:1073065439
Name:DALY, JOSEPH ROBERT IV (EDD, LPC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ROBERT
Last Name:DALY
Suffix:IV
Gender:M
Credentials:EDD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12617 HORSESHOE BAY CT
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-3243
Mailing Address - Country:US
Mailing Address - Phone:804-840-3340
Mailing Address - Fax:
Practice Address - Street 1:7807 COURTHOUSE THREE LN
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23237-2298
Practice Address - Country:US
Practice Address - Phone:804-279-9468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-01
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006705101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional