Provider Demographics
NPI:1558719914
Name:ACKER, DANIELLE (MA)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:ACKER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1910 SHAFFER ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49048-1604
Mailing Address - Country:US
Mailing Address - Phone:269-382-9820
Mailing Address - Fax:269-345-7130
Practice Address - Street 1:1910 SHAFFER ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49048-1604
Practice Address - Country:US
Practice Address - Phone:269-382-9820
Practice Address - Fax:269-345-7130
Is Sole Proprietor?:No
Enumeration Date:2016-05-26
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)