Provider Demographics
NPI:1194397786
Name:AUSTIN, DANIELLE (LCPC)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 GETCHELL ST
Mailing Address - Street 2:
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-2205
Mailing Address - Country:US
Mailing Address - Phone:207-949-0934
Mailing Address - Fax:
Practice Address - Street 1:21 GETCHELL ST
Practice Address - Street 2:
Practice Address - City:BREWER
Practice Address - State:ME
Practice Address - Zip Code:04412-2205
Practice Address - Country:US
Practice Address - Phone:207-949-0934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-13
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC7186101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health