Provider Demographics
NPI:1356429708
Name:MCDANIEL, BRANDY BYTHA (LPC)
Entity type:Individual
Prefix:MRS
First Name:BRANDY
Middle Name:BYTHA
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 AULT RD
Mailing Address - Street 2:
Mailing Address - City:DONALDSON
Mailing Address - State:AR
Mailing Address - Zip Code:71941-8024
Mailing Address - Country:US
Mailing Address - Phone:501-384-5587
Mailing Address - Fax:
Practice Address - Street 1:829 MARTIN LUTHER KING BLVD
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:AR
Practice Address - Zip Code:72104-2637
Practice Address - Country:US
Practice Address - Phone:501-332-4400
Practice Address - Fax:501-332-4403
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP0303006101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health