MEDICARE: CELINE ACYNTHA DANIEL LMHC

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	MH23469	FL

General Provider Information

NPI Number	:	1972793313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CELINE ACYNTHA DANIEL LMHC

Provider Business Mailing Address
First Line	:	4901 26TH ST W STE A
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34207-1708
Country	:	US
Telephone Number	:	941-267-0062
Fax Number	:

Provider Business Practice Location Address
First Line	:	4901 26TH ST W
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34207-1708
Country	:	US
Telephone Number	:	941-267-0062
Fax Number	:

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

Provider Enumeration Date	:	08/01/2007
Last Update Date	:	09/30/2024

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