Provider Demographics
NPI:1992368088
Name:MAGERS, DANIELA STARR (LPC)
Entity Type:Individual
Prefix:MRS
First Name:DANIELA
Middle Name:STARR
Last Name:MAGERS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 MANOR ROW
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-2148
Mailing Address - Country:US
Mailing Address - Phone:912-342-3344
Mailing Address - Fax:
Practice Address - Street 1:127 ABERCORN ST STE 403
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31401-4069
Practice Address - Country:US
Practice Address - Phone:912-342-3344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-15
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC010904101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA831740259Medicaid