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General NPI Number Information
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NPI Number | 1962215665
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Entity Type | Individual
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Provider Name | DANIEL OMALLEY LPCC
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Gender | Male
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Dates
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Enumeration Date | 01/28/2025
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 38100 COLORADO AVE
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City | AVON
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State | OH
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Zip | 44011-1031
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Country | US
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Telephone | 440-961-1008
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Fax |
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Provider Business Mailing Address
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Address Line | 2016 CLARENCE AVE
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City | LAKEWOOD
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State | OH
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Zip | 44107-6204
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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 | E.2404943
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License Number State | OH
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