Healthcare Provider Details

I. General information

NPI: 1710825047
Provider Name (Legal Business Name): DANIELLE PAIGE DOLEN M.ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

859 ALDERSON ST
WILLIAMSON WV
25661-3215
US

IV. Provider business mailing address

130 STONEY MOUNTAIN CAMP ROAD
NORTH MATEWAN WV
25688
US

V. Phone/Fax

Practice location:
  • Phone: 606-625-5465
  • Fax:
Mailing address:
  • Phone: 606-625-5465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: