Healthcare Provider Details

I. General information

NPI: 1679458152
Provider Name (Legal Business Name): DANELLE PERRIZO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2025
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8028 OLD COUNTY ROAD 54
NEW PORT RICHEY FL
34653-6409
US

IV. Provider business mailing address

5441 S MACADAM AVE STE R
PORTLAND OR
97239-3822
US

V. Phone/Fax

Practice location:
  • Phone: 605-601-3091
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberR9594
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberIMT4352
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: