Provider Demographics
NPI:1295211670
Name:CHAVARRIA, DANIEL E (LMHC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:E
Last Name:CHAVARRIA
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 13TH ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50314-2335
Mailing Address - Country:US
Mailing Address - Phone:515-201-5008
Mailing Address - Fax:
Practice Address - Street 1:614 BILLY SUNDAY RD STE 100
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-8048
Practice Address - Country:US
Practice Address - Phone:515-337-1764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-18
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA082656101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health