Provider Demographics
NPI:1396849337
Name:MCNEILL, DANIELE P (PHD)
Entity Type:Individual
Prefix:
First Name:DANIELE
Middle Name:P
Last Name:MCNEILL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:DANIELE
Other - Middle Name:P
Other - Last Name:POWER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:729 TRIO LANE
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-6860
Mailing Address - Country:US
Mailing Address - Phone:757-557-6328
Mailing Address - Fax:
Practice Address - Street 1:729 TRIO LN
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-5931
Practice Address - Country:US
Practice Address - Phone:757-557-6328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-11
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0801000927103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA680000862Medicaid
VA1396849337Medicaid
VA042754OtherANTHEM