MEDICARE: DANIELLA NEMECEK 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	101YA0400X	Addiction (Substance Use Disorder) Counselor	89510	TX
2	101YM0800X	Mental Health Counselor	89510	TX
3	101YP2500X	Professional Counselor	89510	TX

General Provider Information

NPI Number	:	1659215523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLA NEMECEK LPC

Provider Business Mailing Address
First Line	:	9041 LEO ST
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79904-1247
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9041 LEO ST
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79904-1247
Country	:	US
Telephone Number	:	915-491-8565
Fax Number	:

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

Provider Enumeration Date	:	04/20/2026
Last Update Date	:	04/20/2026

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