Provider Demographics
NPI:1629955406
Name:WOLOSZYN, DANIEL B
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:B
Last Name:WOLOSZYN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13450 BECKWITH DR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46074-8337
Mailing Address - Country:US
Mailing Address - Phone:847-826-0476
Mailing Address - Fax:847-826-0476
Practice Address - Street 1:13450 BECKWITH DR
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46074-8337
Practice Address - Country:US
Practice Address - Phone:847-826-0476
Practice Address - Fax:847-826-0476
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-21
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20040717103T00000X
IL071004523103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist