Provider Demographics
NPI:1851860514
Name:BELLER, DANIELLE KAY (MA, LLPC)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:KAY
Last Name:BELLER
Suffix:
Gender:F
Credentials:MA, LLPC
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:K
Other - Last Name:RIBBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LLPC
Mailing Address - Street 1:6369 ENCANTADO CT W
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49341-9621
Mailing Address - Country:US
Mailing Address - Phone:616-292-2083
Mailing Address - Fax:
Practice Address - Street 1:4467 CASCADE RD SE STE 4481
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-3776
Practice Address - Country:US
Practice Address - Phone:616-292-2083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-24
Last Update Date:2018-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401008575101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor