Provider Demographics
NPI:1083960330
Name:STAVA, DANIEL JOSEPH (PLMHP)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:JOSEPH
Last Name:STAVA
Suffix:
Gender:M
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5824 S 142ND ST STE A
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-2872
Mailing Address - Country:US
Mailing Address - Phone:402-598-2725
Mailing Address - Fax:
Practice Address - Street 1:5824 S 142ND ST STE A
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-2872
Practice Address - Country:US
Practice Address - Phone:402-598-2725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor