Provider Demographics
NPI:1114283546
Name:HOWELL-DANIEL, THERALENE JEAN (LLPC)
Entity Type:Individual
Prefix:MS
First Name:THERALENE
Middle Name:JEAN
Last Name:HOWELL-DANIEL
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15151
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48215-0151
Mailing Address - Country:US
Mailing Address - Phone:313-753-2773
Mailing Address - Fax:
Practice Address - Street 1:1530 MONTCLAIR ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48214-4620
Practice Address - Country:US
Practice Address - Phone:313-753-2773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-10
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401012675101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor