Provider Demographics
NPI:1790418101
Name:GARRETT, DANIELA ESTEFANIA (MA, LCMHC-A, NCC)
Entity Type:Individual
Prefix:
First Name:DANIELA
Middle Name:ESTEFANIA
Last Name:GARRETT
Suffix:
Gender:F
Credentials:MA, LCMHC-A, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8130 KINGS CREEK DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-5618
Mailing Address - Country:US
Mailing Address - Phone:910-495-4405
Mailing Address - Fax:
Practice Address - Street 1:18145 W CATAWBA AVE
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-5641
Practice Address - Country:US
Practice Address - Phone:704-756-1615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-04
Last Update Date:2022-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA17630101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty