Provider Demographics
NPI:1821862756
Name:BERKEL, DANIELLE (PHD)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:BERKEL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6050 STETSON HILLS BLVD UNIT 412
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923-3562
Mailing Address - Country:US
Mailing Address - Phone:719-204-6141
Mailing Address - Fax:
Practice Address - Street 1:7825 ANTELOPE MEADOWS CIR
Practice Address - Street 2:
Practice Address - City:PEYTON
Practice Address - State:CO
Practice Address - Zip Code:80831-5027
Practice Address - Country:US
Practice Address - Phone:719-204-6141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-10
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY.0006220103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty