MEDICARE: MILAN DANIEL LPC, NCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	21343	AZ
2	101YP2500X	Professional Counselor	101074	TX

General Provider Information

NPI Number	:	1255055588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MILAN DANIEL LPC, NCC

Provider Business Mailing Address
First Line	:	2760 W PEORIA AVE # 1064
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-5202
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11225 N 28TH DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-5606
Country	:	US
Telephone Number	:	602-456-1360
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2022
Last Update Date	:	01/12/2026

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