Provider Demographics
NPI:1578703021
Name:PHANEUF, DANIELLE JOY (MS, MFT)
Entity Type:Individual
Prefix:MISS
First Name:DANIELLE
Middle Name:JOY
Last Name:PHANEUF
Suffix:
Gender:F
Credentials:MS, MFT
Other - Prefix:MRS
Other - First Name:DANIELLE
Other - Middle Name:JOY
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, MFT
Mailing Address - Street 1:3620 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2020
Mailing Address - Country:US
Mailing Address - Phone:602-230-7373
Mailing Address - Fax:
Practice Address - Street 1:308 W STATE ST STE 3D
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-4653
Practice Address - Country:US
Practice Address - Phone:909-566-9669
Practice Address - Fax:909-353-4985
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-24
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMFT-15473106H00000X
CA52436106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist