Provider Demographics
NPI:1831465129
Name:STANLEY, DANIELLE FAITH (BCBA)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:FAITH
Last Name:STANLEY
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3760 CRANSWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-6332
Mailing Address - Country:US
Mailing Address - Phone:719-213-4630
Mailing Address - Fax:
Practice Address - Street 1:1175 S PERRY ST STE 100
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-1969
Practice Address - Country:US
Practice Address - Phone:720-949-7815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-30
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0-11-4367103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
0-11-4367OtherBACB CERTIFICATION