Healthcare Provider Details

I. General information

NPI: 1386227585
Provider Name (Legal Business Name): DANIEL SHAHEEN LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2021
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3754 PLEASANT AVE STE 205
MINNEAPOLIS MN
55409-1279
US

IV. Provider business mailing address

3754 PLEASANT AVE STE 205
MINNEAPOLIS MN
55409-1279
US

V. Phone/Fax

Practice location:
  • Phone: 612-217-1117
  • Fax:
Mailing address:
  • Phone: 612-217-1117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPRC200001781
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC14367
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC01270
License Number StateRI
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2835
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: