Provider Demographics
NPI:1093401523
Name:CONNELL, DANIELLE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:
Last Name:CONNELL
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 1:368 TIOGA AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18704-5117
Mailing Address - Country:US
Mailing Address - Phone:570-287-9681
Mailing Address - Fax:
Practice Address - Street 1:200 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:TUNKHANNOCK
Practice Address - State:PA
Practice Address - Zip Code:18657-1229
Practice Address - Country:US
Practice Address - Phone:570-836-3111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC015614101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional