Provider Demographics
NPI:1790001642
Name:DANIELS, MARGARET EVA (LPC)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:EVA
Last Name:DANIELS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:EVA
Other - Last Name:PROCTOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:1533 MARSHALL STREET
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101
Mailing Address - Country:US
Mailing Address - Phone:318-626-5597
Mailing Address - Fax:318-626-5691
Practice Address - Street 1:1533 MARSHALL STREET
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101
Practice Address - Country:US
Practice Address - Phone:318-626-5597
Practice Address - Fax:318-626-5691
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-18
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7024101YP2500X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional