Vivian Daniel

Individual provider Active NPI Mental Health Counselor · Avondale Estates, GA

NPI 1003455338 · NPPES record last updated Jan 3, 2020

Key facts

NPI
1003455338
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
151 Locust St
Avondale Estates, GA 30002-1050
Phone
(678) 940-8671
NPI assigned
Jan 3, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

151 Locust St
Avondale Estates, GA 30002-1050

Mailing address

151 Locust St
Avondale Estates, GA 30002-1050

Other providers in Avondale Estates, GA

All providers in Avondale Estates, GA · Mental Health Counselor in Georgia

Sources for this page

Verify at the official NPI Registry.