Provider Demographics
NPI:1992015242
Name:MERCHANT, DANIEL GEORGE (LPC)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:GEORGE
Last Name:MERCHANT
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 HULEN BEND LN APT 107
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-3147
Mailing Address - Country:US
Mailing Address - Phone:682-432-5203
Mailing Address - Fax:
Practice Address - Street 1:3807 E LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76103-3522
Practice Address - Country:US
Practice Address - Phone:817-413-9463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-19
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66408101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional