Provider Demographics
NPI:1376877183
Name:HALLANDALE COUNSELING INC
Entity Type:Organization
Organization Name:HALLANDALE COUNSELING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ARGENE
Authorized Official - Middle Name:K
Authorized Official - Last Name:DANIELIOES
Authorized Official - Suffix:
Authorized Official - Credentials:LICENSED PHD
Authorized Official - Phone:386-677-3995
Mailing Address - Street 1:595 W. GRANADA BLVD
Mailing Address - Street 2:SUITE H
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174
Mailing Address - Country:US
Mailing Address - Phone:386-677-3995
Mailing Address - Fax:386-677-7797
Practice Address - Street 1:595 W. GRANADA BLVD
Practice Address - Street 2:SUITE H
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174
Practice Address - Country:US
Practice Address - Phone:386-677-3995
Practice Address - Fax:386-677-7797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-25
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY3869103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL205861700Medicaid
FL75927AMedicare PIN