Active NPI
Lauren Daniel
- Clinical Child & Adolescent Psychologist
- Philadelphia, PA
National Provider Identifier
1487025417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- PS017867
- Practice address
- 3401 Civic Center Blvd
Philadelphia, PA 19104 - Phone
- (215) 590-7555
- Fax
- (215) 590-7387
- NPI assigned
- Oct 16, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | PS017867 | PA | Primary |
Addresses
Primary practice location
3401 Civic Center Blvd
Philadelphia, PA 19104
Mailing address
3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-7555
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS017867 | PA | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444953600000",
"number": "1487025417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3401 CIVIC CENTER BLVD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19104",
"telephone_number": "215-590-7555",
"fax_number": "215-590-7387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 CIVIC CENTER BLVD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19104",
"telephone_number": "215-590-7555",
"fax_number": "215-590-7387"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANIEL",
"first_name": "LAUREN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-16",
"last_updated": "2015-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "PA",
"license": "PS017867",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.