Provider Demographics
NPI:1134473606
Name:MCINTYRE, DANIELLE M (LMFT)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:M
Last Name:MCINTYRE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 429
Mailing Address - Street 2:24401 W. MCARTHUR RD.
Mailing Address - City:GODDARD
Mailing Address - State:KS
Mailing Address - Zip Code:67052-8713
Mailing Address - Country:US
Mailing Address - Phone:316-794-2760
Mailing Address - Fax:316-794-2773
Practice Address - Street 1:635 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-3602
Practice Address - Country:US
Practice Address - Phone:316-660-7525
Practice Address - Fax:316-660-1897
Is Sole Proprietor?:No
Enumeration Date:2012-11-05
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2442106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist