Provider Demographics
NPI:1720768179
Name:MCDANIEL FLOWERS, NICHELLE RENEE (MA, LPC)
Entity Type:Individual
Prefix:
First Name:NICHELLE
Middle Name:RENEE
Last Name:MCDANIEL FLOWERS
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:MCDANIEL
Other - Last Name:FLOWERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, LPC
Mailing Address - Street 1:133 W SPRINGBROOK RD
Mailing Address - Street 2:
Mailing Address - City:BROADWAY
Mailing Address - State:VA
Mailing Address - Zip Code:22815-9527
Mailing Address - Country:US
Mailing Address - Phone:540-671-6817
Mailing Address - Fax:540-896-7687
Practice Address - Street 1:133 W SPRINGBROOK RD
Practice Address - Street 2:
Practice Address - City:BROADWAY
Practice Address - State:VA
Practice Address - Zip Code:22815-9527
Practice Address - Country:US
Practice Address - Phone:540-671-6817
Practice Address - Fax:540-896-7687
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701012697101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional