Provider Demographics
NPI:1023997293
Name:DANIELS, KELLIE ANN
Entity type:Individual
Prefix:
First Name:KELLIE
Middle Name:ANN
Last Name:DANIELS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KELLIE
Other - Middle Name:ANN
Other - Last Name:BIKSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:M ED
Mailing Address - Street 1:1055 WISTERIA DR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-5419
Mailing Address - Country:US
Mailing Address - Phone:409-781-5450
Mailing Address - Fax:
Practice Address - Street 1:1055 WISTERIA DR
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-5419
Practice Address - Country:US
Practice Address - Phone:409-781-5450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-30
Last Update Date:2025-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional