Provider Demographics
NPI:1356747893
Name:CARDWELL, DANA (LPC)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:CARDWELL
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 1:320 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-4407
Mailing Address - Country:US
Mailing Address - Phone:830-285-5095
Mailing Address - Fax:830-896-3772
Practice Address - Street 1:320 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-4407
Practice Address - Country:US
Practice Address - Phone:830-285-5095
Practice Address - Fax:830-896-3772
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-11
Last Update Date:2014-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69560101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional