Healthcare Provider Details

I. General information

NPI: 1902579824
Provider Name (Legal Business Name): DANIEL ALBERTO HERRERA DENT ED.S, LCPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DANI HERRERA DENT ED.S, LCPC

II. Dates (important events)

Enumeration Date: 07/27/2021
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 N WABASH AVE STE 100
CHICAGO IL
60602-1903
US

IV. Provider business mailing address

6633 N SHERIDAN RD APT 203
CHICAGO IL
60626-4655
US

V. Phone/Fax

Practice location:
  • Phone: 440-532-3985
  • Fax:
Mailing address:
  • Phone: 440-532-3985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180017102
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: