Provider Demographics
NPI:1598815581
Name:VERONDA, DANIEL E (LCPC)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:E
Last Name:VERONDA
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1488
Mailing Address - Street 2:2960 CHARTRES STREET
Mailing Address - City:LA SALLE
Mailing Address - State:IL
Mailing Address - Zip Code:61301-3488
Mailing Address - Country:US
Mailing Address - Phone:815-224-1610
Mailing Address - Fax:815-223-1634
Practice Address - Street 1:727 E ETNA RD
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:IL
Practice Address - Zip Code:61350-1040
Practice Address - Country:US
Practice Address - Phone:815-434-4727
Practice Address - Fax:815-434-0271
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health