Provider Demographics
NPI:1538674130
Name:DANIELLE NAHAS PROFESSIONAL ASSOCIATION
Entity Type:Organization
Organization Name:DANIELLE NAHAS PROFESSIONAL ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CALIFORNIA LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:NAHAS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:415-902-7879
Mailing Address - Street 1:1314 E LAS OLAS BLVD # 1079
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-2334
Mailing Address - Country:US
Mailing Address - Phone:415-902-7879
Mailing Address - Fax:858-437-6450
Practice Address - Street 1:115 E PALM MIDWAY
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-5145
Practice Address - Country:US
Practice Address - Phone:415-902-7879
Practice Address - Fax:858-437-6450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-05
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-13-13509103K00000X
CA27313103T00000X, 103T00000X
FL1329103TS0200X
CA2834103TS0200X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1073869632OtherNPI