Provider Demographics
NPI:1255052593
Name:DANIELLE ESCOBAR THERAPY
Entity type:Organization
Organization Name:DANIELLE ESCOBAR THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ESCOBAR
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:860-917-4925
Mailing Address - Street 1:82 HEATHERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06415-1807
Mailing Address - Country:US
Mailing Address - Phone:860-917-4925
Mailing Address - Fax:
Practice Address - Street 1:82 HEATHERWOOD DR
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06415-1807
Practice Address - Country:US
Practice Address - Phone:860-917-4925
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty