Provider Demographics
NPI:1922407519
Name:DANIELS, ELIZABETH KATHLEEN (LPCC)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:KATHLEEN
Last Name:DANIELS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4512 TOPAZ AVE NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-5064
Mailing Address - Country:US
Mailing Address - Phone:505-903-4413
Mailing Address - Fax:
Practice Address - Street 1:3846 RIO GRANDE BLVD NW STE A
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-3052
Practice Address - Country:US
Practice Address - Phone:505-903-4413
Practice Address - Fax:505-856-6320
Is Sole Proprietor?:No
Enumeration Date:2014-08-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0168581101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health