Provider Demographics
NPI:1639743818
Name:SEXTON, DANIEL WYATT (LMHC, CASAC 2)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:WYATT
Last Name:SEXTON
Suffix:
Gender:M
Credentials:LMHC, CASAC 2
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2852
Mailing Address - Country:US
Mailing Address - Phone:631-456-4821
Mailing Address - Fax:631-456-4821
Practice Address - Street 1:141 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2852
Practice Address - Country:US
Practice Address - Phone:631-456-4821
Practice Address - Fax:631-456-4821
Is Sole Proprietor?:No
Enumeration Date:2021-05-13
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY36298101YA0400X
NY011342-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)