Provider Demographics
NPI:1952575151
Name:CORLEY, DAN ALAN (PHD, LPC, NCC, CCMHC)
Entity type:Individual
Prefix:DR
First Name:DAN
Middle Name:ALAN
Last Name:CORLEY
Suffix:
Gender:M
Credentials:PHD, LPC, NCC, CCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 FOREST GROVE ESTATES RD
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-8320
Mailing Address - Country:US
Mailing Address - Phone:972-838-0434
Mailing Address - Fax:
Practice Address - Street 1:2111 FOREST GROVE ESTATES RD
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-8320
Practice Address - Country:US
Practice Address - Phone:972-838-0434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-17
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK946101YP2500X
TX18578101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional