MEDICARE: DANELLE GREENE KIZIAH LCMHC

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	18321	NC

General Provider Information

NPI Number	:	1992654990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANELLE GREENE KIZIAH LCMHC

Provider Business Mailing Address
First Line	:	1836 CANDLELIGHT FARM LN
Second Line	:
City	:	LENOIR
State	:	NC
Zip	:	28645-8357
Country	:	US
Telephone Number	:	828-493-0392
Fax Number	:

Provider Business Practice Location Address
First Line	:	1836 CANDLELIGHT FARM LN
Second Line	:
City	:	LENOIR
State	:	NC
Zip	:	28645-8357
Country	:	US
Telephone Number	:	828-493-0392
Fax Number	:

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

Provider Enumeration Date	:	01/23/2026
Last Update Date	:	01/23/2026

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