Healthcare Provider Details

I. General information

NPI: 1699278911
Provider Name (Legal Business Name): DANIELLE PRICE LPC, AADC, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DANIELLE BERTHA

II. Dates (important events)

Enumeration Date: 03/13/2018
Last Update Date: 12/04/2023
Certification Date: 12/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4507 LAUREL RIDGE DR
MORGANTOWN WV
26508-8687
US

IV. Provider business mailing address

4507 LAUREL RIDGE DR
MORGANTOWN WV
26508-8687
US

V. Phone/Fax

Practice location:
  • Phone: 301-616-5707
  • Fax:
Mailing address:
  • Phone: 484-723-3197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number15-117
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2221
License Number StateWV
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14308
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: