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General NPI Number Information
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NPI Number | 1629738240
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Entity Type | Individual
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Provider Name | DANIEL CRANDALL LCPC
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Gender | Male
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Dates
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Enumeration Date | 12/22/2021
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Last Update Date | 12/22/2021
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Provider Practice Location Address
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Address Line | 7007 BRADLEY BLVD
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City | BETHESDA
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State | MD
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Zip | 20817-2149
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Country | US
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Telephone | 301-767-1733
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Fax |
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Provider Business Mailing Address
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Address Line | 6603 EDSALL RD
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City | SPRINGFIELD
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State | VA
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Zip | 22151-3863
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Country | US
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Telephone | 434-305-9504
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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 | LC10053
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License Number State | MD
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