Provider Demographics
NPI:1215602826
Name:DANIELLE CICCONE, LICENSED PROFESSIONAL CLINICAL COUNSELOR, INC.
Entity Type:Organization
Organization Name:DANIELLE CICCONE, LICENSED PROFESSIONAL CLINICAL COUNSELOR, INC.
Other - Org Name:AGOURA HILLS COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CICCONE
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:818-658-2137
Mailing Address - Street 1:30101 AGOURA CT STE 150
Mailing Address - Street 2:
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-4369
Mailing Address - Country:US
Mailing Address - Phone:818-658-2137
Mailing Address - Fax:
Practice Address - Street 1:30101 AGOURA CT STE 150
Practice Address - Street 2:
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-4369
Practice Address - Country:US
Practice Address - Phone:818-658-2137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-16
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty