Provider Demographics
NPI:1821203860
Name:HOLBROOK, DANELLE BROWN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:DANELLE
Middle Name:BROWN
Last Name:HOLBROOK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6718 MOUNTING ROCK RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28217-3498
Mailing Address - Country:US
Mailing Address - Phone:508-958-0520
Mailing Address - Fax:508-339-2334
Practice Address - Street 1:6718 MOUNTING ROCK RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28217-3498
Practice Address - Country:US
Practice Address - Phone:508-958-0520
Practice Address - Fax:508-339-2334
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6474101YP2500X
MA5729101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional