Provider Demographics
NPI:1356625289
Name:MCANINCH, DANIEL (BS, LCDC-I)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:
Last Name:MCANINCH
Suffix:
Gender:M
Credentials:BS, LCDC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1333
Mailing Address - Street 2:
Mailing Address - City:CORSICANA
Mailing Address - State:TX
Mailing Address - Zip Code:75151-1333
Mailing Address - Country:US
Mailing Address - Phone:903-530-6728
Mailing Address - Fax:
Practice Address - Street 1:100 N MAIN ST
Practice Address - Street 2:SUITE 519
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-5273
Practice Address - Country:US
Practice Address - Phone:903-530-6728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-11
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14187101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)