Provider Demographics
NPI:1629756614
Name:SEPULVEDA, DANIELLE MAYTEE (LMHC)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:MAYTEE
Last Name:SEPULVEDA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 NW 150TH AVE STE 2109
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-2870
Mailing Address - Country:US
Mailing Address - Phone:786-317-2668
Mailing Address - Fax:
Practice Address - Street 1:2000 NW 150TH AVE STE 2109
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-2870
Practice Address - Country:US
Practice Address - Phone:786-577-8204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH21324101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health