Provider Demographics
NPI:1598234536
Name:MASSEY, DANIEL JACKSON JR (LPC, LCADC)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:JACKSON
Last Name:MASSEY
Suffix:JR
Gender:M
Credentials:LPC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 SHELLEY DR STE 2E
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-2530
Mailing Address - Country:US
Mailing Address - Phone:646-872-7488
Mailing Address - Fax:908-979-1600
Practice Address - Street 1:121 SHELLEY DR STE 2E
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-2530
Practice Address - Country:US
Practice Address - Phone:646-872-7488
Practice Address - Fax:908-979-1600
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-20
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00930200101YP2500X
NJ37LC00290300101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1326412008OtherNPI 2