Provider Demographics
NPI:1669109559
Name:DDLMFT, P.C.
Entity type:Organization
Organization Name:DDLMFT, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DAUGHTRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:252-883-6202
Mailing Address - Street 1:3501 MANSFIELD DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27803-1211
Mailing Address - Country:US
Mailing Address - Phone:252-883-6202
Mailing Address - Fax:252-937-7981
Practice Address - Street 1:876 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-1707
Practice Address - Country:US
Practice Address - Phone:252-883-6202
Practice Address - Fax:252-937-7981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty