Provider Demographics
NPI:1417304494
Name:O'WADE, DANIELLE CARRIE (MA LPC NCC)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:CARRIE
Last Name:O'WADE
Suffix:
Gender:F
Credentials:MA LPC NCC
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:CARRIE
Other - Last Name:DUPRES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA LPC NCC
Mailing Address - Street 1:1630 ROSTRAVER ROAD
Mailing Address - Street 2:
Mailing Address - City:BELLE VERNON
Mailing Address - State:PA
Mailing Address - Zip Code:15012
Mailing Address - Country:US
Mailing Address - Phone:724-757-2845
Mailing Address - Fax:
Practice Address - Street 1:510 CIRCLE DRIVE
Practice Address - Street 2:SUITE 103
Practice Address - City:ROSTRAVER TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:15012
Practice Address - Country:US
Practice Address - Phone:724-757-2845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-19
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC008938101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor