Provider Demographics
NPI:1144530957
Name:ROSENBLATT, DANIELLE MEGAN (LCPC)
Entity type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:MEGAN
Last Name:ROSENBLATT
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1614 SHAKESPEARE ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21231-3426
Mailing Address - Country:US
Mailing Address - Phone:484-432-1204
Mailing Address - Fax:
Practice Address - Street 1:4 PROFESSIONAL DR
Practice Address - Street 2:#120
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879-3407
Practice Address - Country:US
Practice Address - Phone:484-432-1204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-14
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC4524101YP2500X
MA7844101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health