MEDICARE: MRS. DANIELLE CHRISTINE DARDEN MS, LBSC, LPC, NCC

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	101Y00000X	Counselor	BH002753	PA
2	101YP2500X	Professional Counselor	PC014251	PA

General Provider Information

NPI Number	:	1679015200
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DANIELLE CHRISTINE DARDEN MS, LBSC, LPC, NCC

Provider Business Mailing Address
First Line	:	87 OLD CEDARBROOK RD
Second Line	:
City	:	WYNCOTE
State	:	PA
Zip	:	19095-2045
Country	:	US
Telephone Number	:	215-341-1020
Fax Number	:

Provider Business Practice Location Address
First Line	:	2630 W CHELTENHAM AVE FL 1
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19150-1311
Country	:	US
Telephone Number	:	215-341-1020
Fax Number	:	267-627-2848

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

Provider Enumeration Date	:	11/14/2016
Last Update Date	:	04/19/2022

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