Provider Demographics
NPI:1760762611
Name:ORT, DANIEL JAMES (LMHC, CASAC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:JAMES
Last Name:ORT
Suffix:
Gender:M
Credentials:LMHC, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 11 ST
Mailing Address - Street 2:NORTHPOINTE COUNCIL INC.
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14301
Mailing Address - Country:US
Mailing Address - Phone:716-278-8110
Mailing Address - Fax:716-278-8111
Practice Address - Street 1:1001 11 ST
Practice Address - Street 2:NORTHPOINTE COUNCIL INC.
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14301
Practice Address - Country:US
Practice Address - Phone:716-278-8110
Practice Address - Fax:716-278-8111
Is Sole Proprietor?:No
Enumeration Date:2011-08-24
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP80139101Y00000X, 101YA0400X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00932467Medicaid