Healthcare Provider Details

I. General information

NPI: 1497580526
Provider Name (Legal Business Name): DANIELLE COONS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2024
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2423 HIGHWAY 17 S # 1281
NORTH MYRTLE BEACH SC
29582-4343
US

IV. Provider business mailing address

2423 HIGHWAY 17 S # 1281
NORTH MYRTLE BEACH SC
29582-4343
US

V. Phone/Fax

Practice location:
  • Phone: 843-591-5401
  • Fax:
Mailing address:
  • Phone: 843-591-5401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number10187
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: