Provider Demographics
NPI:1275964678
Name:CICCONE, DANIELLE LYNNE (MS, LPCC)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:LYNNE
Last Name:CICCONE
Suffix:
Gender:F
Credentials:MS, LPCC
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:LYNNE
Other - Last Name:JOEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30101 AGOURA COURT
Mailing Address - Street 2:LOBBY 3, SUITE 150
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-4519
Mailing Address - Country:US
Mailing Address - Phone:818-658-2137
Mailing Address - Fax:
Practice Address - Street 1:30101 AGOURA COURT
Practice Address - Street 2:LOBBY 3, SUITE 150
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-4341
Practice Address - Country:US
Practice Address - Phone:818-658-2137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-10
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPCC4677101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health