Provider Demographics
NPI:1649547522
Name:LUOMA, DANIEL WESLEY (MSW, CAP, CMHP)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:WESLEY
Last Name:LUOMA
Suffix:
Gender:M
Credentials:MSW, CAP, CMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 S HIGHWAY 79
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32413-2151
Mailing Address - Country:US
Mailing Address - Phone:850-249-4300
Mailing Address - Fax:850-640-1174
Practice Address - Street 1:220 S HIGHWAY 79
Practice Address - Street 2:
Practice Address - City:PANAMA CITY BEACH
Practice Address - State:FL
Practice Address - Zip Code:32413-2151
Practice Address - Country:US
Practice Address - Phone:850-249-4300
Practice Address - Fax:850-640-1174
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-21
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator