Provider Demographics
NPI:1083057905
Name:KAUDER, DANIEL WESLEY (MA, LPC)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:WESLEY
Last Name:KAUDER
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 LINCOLN AVE N
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-2344
Mailing Address - Country:US
Mailing Address - Phone:443-618-5275
Mailing Address - Fax:
Practice Address - Street 1:1777 SENTRY PKWY W STE 300
Practice Address - Street 2:
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-2211
Practice Address - Country:US
Practice Address - Phone:443-618-5275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
PAPC007453101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health