MEDICARE: NANCY DANIELLE CLANCY

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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1528947967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY DANIELLE CLANCY

Provider Business Mailing Address
First Line	:	16400 US HIGHWAY 331 STE B2 # 112
Second Line	:
City	:	FREEPORT
State	:	FL
Zip	:	32439
Country	:	US
Telephone Number	:	910-651-6910
Fax Number	:

Provider Business Practice Location Address
First Line	:	348 MIRACLE STRIP PKWY SW STE 24
Second Line	:
City	:	FORT WALTON BEACH
State	:	FL
Zip	:	32548-5263
Country	:	US
Telephone Number	:	850-498-6858
Fax Number	:	251-930-6837

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

Provider Enumeration Date	:	08/29/2025
Last Update Date	:	08/29/2025

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Directions to “ NANCY DANIELLE CLANCY ” Practice Location

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