Provider Demographics
NPI:1982192944
Name:OLNEY-DIEHL, DANIELLE ALICIA-DANTE (LICDC, QMHS, TTS)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:ALICIA-DANTE
Last Name:OLNEY-DIEHL
Suffix:
Gender:F
Credentials:LICDC, QMHS, TTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 BOWMAN ST
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44903-1235
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:839 E MARKET ST STE 126
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44305-2460
Practice Address - Country:US
Practice Address - Phone:330-338-6174
Practice Address - Fax:888-954-3777
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-25
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLCDCII.161431101YA0400X
OHLICDC.162174101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)