Provider Demographics
NPI:1821534348
Name:FICKEN, DANIELLE KEEL (MS, LPCA, NCC)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:KEEL
Last Name:FICKEN
Suffix:
Gender:F
Credentials:MS, LPCA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 QUAIL DR
Mailing Address - Street 2:
Mailing Address - City:DUDLEY
Mailing Address - State:NC
Mailing Address - Zip Code:28333-9518
Mailing Address - Country:US
Mailing Address - Phone:919-222-5632
Mailing Address - Fax:
Practice Address - Street 1:1706 WAYNE MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-2240
Practice Address - Country:US
Practice Address - Phone:919-734-6676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-07
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA12723101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional