Healthcare Provider Details

I. General information

NPI: 1093636029
Provider Name (Legal Business Name): ALAN LENNIS DANIEL LMHC, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 HARRISON PARK LANE
BURLINGTON NJ
08016
US

IV. Provider business mailing address

3 HARRISON PARK LANE
BURLINGTON NJ
08016
US

V. Phone/Fax

Practice location:
  • Phone: 609-227-7193
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number87000086A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39000057A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: