MEDICARE: DANIELLE G. MOREAU LMHC

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	101YM0800X	Mental Health Counselor	8280	MA

General Provider Information

NPI Number	:	1639419567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE G. MOREAU LMHC

Provider Business Mailing Address
First Line	:	1546 OLD PLAINVILLE RD
Second Line	:
City	:	DARTMOUTH
State	:	MA
Zip	:	02747-1408
Country	:	US
Telephone Number	:	508-991-7847
Fax Number	:

Provider Business Practice Location Address
First Line	:	1546 OLD PLAINVILLE RD
Second Line	:
City	:	DARTMOUTH
State	:	MA
Zip	:	02747-1408
Country	:	US
Telephone Number	:	508-287-7980
Fax Number	:

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

Provider Enumeration Date	:	03/01/2013
Last Update Date	:	03/01/2013

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