Healthcare Provider Details

I. General information

NPI: 1467918896
Provider Name (Legal Business Name): DANIELLE BREANN GERMAINE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2019
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 W BROAD ST
LINDEN MI
48451-8645
US

IV. Provider business mailing address

2222 S CRAWFORD RD APT G24
MOUNT PLEASANT MI
48858-9358
US

V. Phone/Fax

Practice location:
  • Phone: 810-936-0079
  • Fax:
Mailing address:
  • Phone: 443-745-9540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6401019377
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: