Provider Demographics
NPI:1982913471
Name:DANIELS, SQUIRE REUBEN JR (LPC)
Entity Type:Individual
Prefix:MR
First Name:SQUIRE
Middle Name:REUBEN
Last Name:DANIELS
Suffix:JR
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 M ST SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-3609
Mailing Address - Country:US
Mailing Address - Phone:202-547-3870
Mailing Address - Fax:
Practice Address - Street 1:770 M ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-3609
Practice Address - Country:US
Practice Address - Phone:202-547-3870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-30
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC-321101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional