Provider Demographics
NPI:1396054532
Name:MCDANIEL, MEREDITH DIANE (MA, LPCA)
Entity type:Individual
Prefix:MRS
First Name:MEREDITH
Middle Name:DIANE
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:MA, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DAVIDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28036-9086
Mailing Address - Country:US
Mailing Address - Phone:336-255-5643
Mailing Address - Fax:
Practice Address - Street 1:263 3RD AVE NW
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-4911
Practice Address - Country:US
Practice Address - Phone:828-322-4941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-06
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA8254101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional