Provider Demographics
NPI:1477046688
Name:MUMPTON, DANIELLE ELIZABETH (LPCC)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:ELIZABETH
Last Name:MUMPTON
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3763 N HIGH ST STE A
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3547
Mailing Address - Country:US
Mailing Address - Phone:614-398-0689
Mailing Address - Fax:866-594-7023
Practice Address - Street 1:3763 N HIGH ST STE A
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3547
Practice Address - Country:US
Practice Address - Phone:614-398-0689
Practice Address - Fax:866-594-7023
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-12
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1800665101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health