Provider Demographics
NPI:1861510398
Name:HACKETT, DANIELLE E (MA, LCPC)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:E
Last Name:HACKETT
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:E
Other - Last Name:HACKETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCPC
Mailing Address - Street 1:14 UNION ST
Mailing Address - Street 2:NONE
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-3146
Mailing Address - Country:US
Mailing Address - Phone:207-951-1852
Mailing Address - Fax:207-858-7732
Practice Address - Street 1:470 FOREST AVE
Practice Address - Street 2:NONE
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-2009
Practice Address - Country:US
Practice Address - Phone:303-449-2217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2011-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health