Provider Demographics
NPI:1740504919
Name:DANIEL, ROBIN L (PH D LPC)
Entity type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:L
Last Name:DANIEL
Suffix:
Gender:M
Credentials:PH D LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6923 MAYNARD RD
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27358-9206
Mailing Address - Country:US
Mailing Address - Phone:336-337-1576
Mailing Address - Fax:336-272-7102
Practice Address - Street 1:6923 MAYNARD RD
Practice Address - Street 2:
Practice Address - City:SUMMERFIELD
Practice Address - State:NC
Practice Address - Zip Code:27358-9206
Practice Address - Country:US
Practice Address - Phone:336-337-1576
Practice Address - Fax:336-272-7102
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-17
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3748101Y00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist