Provider Demographics
NPI:1538398359
Name:DANIELS, JENNIFER LEIGH (LMHC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LEIGH
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 1:503 MAIN ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230-2151
Mailing Address - Country:US
Mailing Address - Phone:413-644-0185
Mailing Address - Fax:
Practice Address - Street 1:503 MAIN ST
Practice Address - Street 2:SUITE 5
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-2151
Practice Address - Country:US
Practice Address - Phone:413-644-0185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-14
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6653101YM0800X
WALH00008383101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health