Individual provider Active NPI

Carol Jean Daniels, PHD LMFT

  • Marriage & Family Therapist
  • Davenport, IA
National Provider Identifier
1447338462
Registry record updated May 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
1333 W. Lombard Street Suite C
Davenport, IA 52804-1701
Phone
(563) 324-9050
Fax
(563) 424-7827
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 166000570 IL
Marriage & Family Therapist 106H00000X IA Primary

Addresses

Primary practice location

1333 W. Lombard Street Suite C
Davenport, IA 52804-1701

Mailing address

1333 W. Lombard Street Suite C
Davenport, IA 52804-1701
Phone (563) 324-9050

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
166000570ILMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558310400000",
    "number": "1447338462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 W. LOMBARD STREET SUITE C",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528041701",
            "telephone_number": "563-324-9050",
            "fax_number": "563-424-7827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 W. LOMBARD STREET SUITE C",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528041701",
            "telephone_number": "563-324-9050",
            "fax_number": "563-424-7827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "CAROL",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "PHD LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2019-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166000570",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.