Provider Demographics
NPI:1326435165
Name:KELLOGG, DANIEL E (CADC - R)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:E
Last Name:KELLOGG
Suffix:
Gender:M
Credentials:CADC - R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 NW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-1524
Mailing Address - Country:US
Mailing Address - Phone:541-955-9227
Mailing Address - Fax:541-734-2410
Practice Address - Street 1:720 NW 6TH ST
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-1524
Practice Address - Country:US
Practice Address - Phone:541-955-9227
Practice Address - Fax:541-734-2410
Is Sole Proprietor?:No
Enumeration Date:2015-04-20
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health