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General NPI Number Information
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NPI Number | 1972734390
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Entity Type | Individual
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Provider Name | ANNETTE MCDANIEL NCC CCMHC LMHC LMT
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Gender | Female
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Dates
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Enumeration Date | 08/03/2009
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Last Update Date | 10/02/2023
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Provider Practice Location Address
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Address Line | 665 DILLARD DR SE VIRTUAL/ONLINE ONLY
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City | PALM BAY
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State | FL
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Zip | 32909
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Country | US
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Telephone | 321-272-5996
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Fax | 321-473-8874
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Provider Business Mailing Address
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Address Line | PO BOX 100156
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City | PALM BAY
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State | FL
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Zip | 32910-0156
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Country | US
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Telephone | 321-272-5996
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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 | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 69138
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 7677
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH15855
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License Number State | FL
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