Provider Demographics
NPI:1518238971
Name:MORELAND, DANIENCE (LPC)
Entity Type:Individual
Prefix:
First Name:DANIENCE
Middle Name:
Last Name:MORELAND
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9419 E 63RD ST
Mailing Address - Street 2:
Mailing Address - City:RAYTOWN
Mailing Address - State:MO
Mailing Address - Zip Code:64133-4903
Mailing Address - Country:US
Mailing Address - Phone:816-726-8770
Mailing Address - Fax:816-817-4666
Practice Address - Street 1:9419 E 63RD ST
Practice Address - Street 2:
Practice Address - City:RAYTOWN
Practice Address - State:MO
Practice Address - Zip Code:64133-4903
Practice Address - Country:US
Practice Address - Phone:816-726-8770
Practice Address - Fax:816-817-4666
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-17
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011016801101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional