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General NPI Number Information
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NPI Number | 1720585151
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Entity Type | Individual
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Provider Name | DANIEL REISS LPC
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Gender | Male
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Dates
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Enumeration Date | 04/11/2018
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Last Update Date | 04/11/2018
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Provider Practice Location Address
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Address Line | 1 INTERNATIONAL BLVD STE 400
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City | MAHWAH
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State | NJ
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Zip | 07495-0025
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Country | US
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Telephone | 845-596-0536
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Fax |
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Provider Business Mailing Address
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Address Line | 6 WOODCREST RD
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City | MONSEY
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State | NY
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Zip | 10952-1028
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 37PC00571100
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License Number State | NJ
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