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General NPI Number Information
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NPI Number | 1417596461
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Entity Type | Individual
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Provider Name | DANIEL LUCEY
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Gender | Male
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Dates
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Enumeration Date | 12/22/2019
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Last Update Date | 05/04/2022
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Provider Practice Location Address
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Address Line | 17111 BEACH BLVD STE 205
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-5947
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Country | US
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Telephone | 714-654-1570
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Fax |
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Provider Business Mailing Address
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Address Line | 23331 EL TORO ROAD, SUITE 208.
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City | LAKE FOREST
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State | CA
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Zip | 92630
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | APCC7205
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 11457
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License Number State | CA
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