Provider Demographics
NPI:1902323785
Name:DANIELS, COURTNEY LEVY (LMHC)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:LEVY
Last Name:DANIELS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4428 PURVES ST APT 11M
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-3071
Mailing Address - Country:US
Mailing Address - Phone:301-792-7926
Mailing Address - Fax:
Practice Address - Street 1:4428 PURVES ST APT 11M
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-3071
Practice Address - Country:US
Practice Address - Phone:301-792-7926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NY007949101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY87-0988402OtherN/A