Provider Demographics
NPI:1508756610
Name:RIBEIRO, DANIEL ALAN (PSYD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ALAN
Last Name:RIBEIRO
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4022 WESTOAK VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:LANESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47136-9475
Mailing Address - Country:US
Mailing Address - Phone:209-617-1493
Mailing Address - Fax:
Practice Address - Street 1:4347 SECURITY PKWY
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-9374
Practice Address - Country:US
Practice Address - Phone:209-617-1493
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI540457103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical