Healthcare Provider Details

I. General information

NPI: 1871406843
Provider Name (Legal Business Name): DANIELLE ANITA LAROCQUE CRNP, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DANI ANITA LAROCQUE

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5813 JUDGE DOBBIN CT
ELKRIDGE MD
21075-6917
US

IV. Provider business mailing address

5813 JUDGE DOBBIN CT
ELKRIDGE MD
21075-6917
US

V. Phone/Fax

Practice location:
  • Phone: 615-707-2152
  • Fax:
Mailing address:
  • Phone: 615-707-2152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0810X
TaxonomyChild & Family Psychiatric/Mental Health Clinical Nurse Specialist
License NumberR273381
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: