Healthcare Provider Details

I. General information

NPI: 1083141279
Provider Name (Legal Business Name): DANIEL UTTS LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2017
Last Update Date: 05/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

527 N MERIDIAN RD
YOUNGSTOWN OH
44509-1227
US

IV. Provider business mailing address

527 N MERIDIAN RD
YOUNGSTOWN OH
44509-1227
US

V. Phone/Fax

Practice location:
  • Phone: 330-270-5334
  • Fax:
Mailing address:
  • Phone: 330-797-0070
  • Fax: 330-797-1501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number1700109
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: