Provider Demographics
NPI:1164634812
Name:DANIELS, AMY HANES (LPC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:HANES
Last Name:DANIELS
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 1:4833 AUDUBON DR STE 214
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36619-8960
Mailing Address - Country:US
Mailing Address - Phone:251-366-1710
Mailing Address - Fax:877-244-0909
Practice Address - Street 1:5821 RANGELINE RD STE 214
Practice Address - Street 2:
Practice Address - City:THEODORE
Practice Address - State:AL
Practice Address - Zip Code:36582-5211
Practice Address - Country:US
Practice Address - Phone:251-366-1710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2441101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional