1982051702 NPI number — DENEE DANIEL MA, CSAC, LPC-R

NPI Number: 1982051702
Health Care Provider/Practitioner: DENEE DANIEL MA, CSAC, LPC-R

NPI Number : 1982051702 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1982051702",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DANIEL",
    "FirstName": "DENEE",
    "MiddleName": null,
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "MA, CSAC, LPC-R",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "PETERS",
    "OtherFirstName": "DENEE",
    "OtherMiddleName": null,
    "OtherNamePrefix": "MRS.",
    "OtherNameSuffix": null,
    "OtherCredential": "CSAC",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "11166 FAIRFAX BLVD STE 500",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FAIRFAX",
    "MailingAddressStateName": "VA",
    "MailingAddressPostalCode": "22030-5017",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "571-441-3028",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "11166 FAIRFAX BLVD STE 500",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FAIRFAX",
    "PracticeLocationAddressStateName": "VA",
    "PracticeLocationAddressPostalCode": "22030-5017",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "571-441-3028",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/22/2016",
    "LastUpdateDate": "07/26/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": "05/25/2020",
    "NPIReactivationDate": "07/22/2026",
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101Y00000X",
          "TaxonomyName": "Counselor",
          "LicenseNumber": "0704007272",
          "LicenseNumberStateCode": "VA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YA0400X",
          "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
          "LicenseNumber": "0710102684",
          "LicenseNumberStateCode": "VA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}