Healthcare Provider Details

I. General information

NPI: 1275340200
Provider Name (Legal Business Name): DANIEL NEIRA MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2024
Last Update Date: 12/13/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 METHUEN ST
LAWRENCE MA
01840-1772
US

IV. Provider business mailing address

12 OLIVER ST APT B
HAVERHILL MA
01832-1337
US

V. Phone/Fax

Practice location:
  • Phone: 978-620-1250
  • Fax:
Mailing address:
  • Phone: 978-397-2219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: