Provider Demographics
NPI:1528400694
Name:DANILOVICH, ANGELA (LMHC)
Entity Type:Individual
Prefix:MISS
First Name:ANGELA
Middle Name:
Last Name:DANILOVICH
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 1:120 W EAGLE ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14202-3810
Mailing Address - Country:US
Mailing Address - Phone:716-858-8045
Mailing Address - Fax:
Practice Address - Street 1:1131 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14212-1501
Practice Address - Country:US
Practice Address - Phone:716-896-7350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-18
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006704101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health