Provider Demographics
NPI:1497580526
Name:COONS, DANIELLE (LPC)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:COONS
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 1:6218 BLYNN DR APT 3
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29572-3248
Mailing Address - Country:US
Mailing Address - Phone:518-505-0139
Mailing Address - Fax:
Practice Address - Street 1:6218 BLYNN DR APT 3
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29572-3248
Practice Address - Country:US
Practice Address - Phone:518-505-0139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10187101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health