Provider Demographics
NPI:1477859080
Name:DANIELS, BEVERLY (LMHC)
Entity Type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:
Last Name:DANIELS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 CROES AVE
Mailing Address - Street 2:APT. 5A
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-4112
Mailing Address - Country:US
Mailing Address - Phone:718-842-8690
Mailing Address - Fax:
Practice Address - Street 1:750 CROES AVE
Practice Address - Street 2:APT. 5A
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-4112
Practice Address - Country:US
Practice Address - Phone:718-842-8690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-28
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003795-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health