Provider Demographics
NPI:1235639287
Name:BENNETT, DANIELLE A'LYCE (LMHC)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:A'LYCE
Last Name:BENNETT
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 SW STATE ST STE 2C
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-2547
Mailing Address - Country:US
Mailing Address - Phone:515-337-0799
Mailing Address - Fax:
Practice Address - Street 1:1200 SW STATE ST STE 2C
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-2547
Practice Address - Country:US
Practice Address - Phone:515-337-0799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-16
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAT16055101YA0400X
IA089784101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)