Provider Demographics
NPI:1184112237
Name:DANIEL, JELANI C (MA, LPC)
Entity type:Individual
Prefix:MR
First Name:JELANI
Middle Name:C
Last Name:DANIEL
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12414 SILENT CREEK DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-1675
Mailing Address - Country:US
Mailing Address - Phone:847-910-6383
Mailing Address - Fax:832-558-1755
Practice Address - Street 1:1977 BUTLER BLVD.
Practice Address - Street 2:E4. 400
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:713-955-8695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-24
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72087101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional