Provider Demographics
NPI:1568046498
Name:OLACIREGUI, DANIEL (MS, LMHC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:OLACIREGUI
Suffix:
Gender:M
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4302 HOLLYWOOD BLVD # 98
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6635
Mailing Address - Country:US
Mailing Address - Phone:754-212-7570
Mailing Address - Fax:
Practice Address - Street 1:555 S LUNA CT APT 304
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-7565
Practice Address - Country:US
Practice Address - Phone:754-212-7570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH172120101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health