Provider Demographics
NPI:1598139271
Name:DANIS, MARIE A (LPC)
Entity Type:Individual
Prefix:MS
First Name:MARIE
Middle Name:A
Last Name:DANIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 GREENRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-3553
Mailing Address - Country:US
Mailing Address - Phone:860-496-9622
Mailing Address - Fax:860-496-9622
Practice Address - Street 1:149 GREENRIDGE RD
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-3553
Practice Address - Country:US
Practice Address - Phone:860-496-9622
Practice Address - Fax:860-496-9622
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-18
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT03-303067101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional