Provider Demographics
NPI:1396945812
Name:ENGLE, DAN R (LMFT)
Entity type:Individual
Prefix:DR
First Name:DAN
Middle Name:R
Last Name:ENGLE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1804 MICCOSUKEE COMMONS DR
Mailing Address - Street 2:SUITE 206
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308
Mailing Address - Country:US
Mailing Address - Phone:850-222-5511
Mailing Address - Fax:850-298-8857
Practice Address - Street 1:1804 MICCOSUKEE COMMONS DR
Practice Address - Street 2:SUITE 206
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308
Practice Address - Country:US
Practice Address - Phone:850-222-5511
Practice Address - Fax:850-298-8857
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT1890106H00000X
FLMT 1890106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL060298103Medicaid