MEDICARE: DANIELLE JOANNA POLIFRONI MPS, LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	001332	OTHER	NY	CREATIVE ARTS THERAPY LICENSE
2	09-172	OTHER		REGISTERED, BOARD CERTIFIED ART THERAPIST

General Provider Information

NPI Number	:	1467702670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE JOANNA POLIFRONI MPS, LPC

Provider Business Mailing Address
First Line	:	2809 XAVIER ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80212-1524
Country	:	US
Telephone Number	:	203-216-5076
Fax Number	:

Provider Business Practice Location Address
First Line	:	2406 W 32ND AVE STE A
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80211-3373
Country	:	US
Telephone Number	:	203-216-5076
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2012
Last Update Date	:	08/23/2022

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