Healthcare Provider Details

I. General information

NPI: 1710807714
Provider Name (Legal Business Name): DANIEL PATRICK MCNAMARA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 WESTERN AVE
BRATTLEBORO VT
05301-6096
US

IV. Provider business mailing address

70 WESTERN AVE
BRATTLEBORO VT
05301-6096
US

V. Phone/Fax

Practice location:
  • Phone: 215-771-8287
  • Fax:
Mailing address:
  • Phone: 215-771-8287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number097.0136887
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: