Provider Demographics
NPI:1730740382
Name:MIRONSKI, DANIELLA (MA, LPC)
Entity type:Individual
Prefix:
First Name:DANIELLA
Middle Name:
Last Name:MIRONSKI
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 FELDMAN CT
Mailing Address - Street 2:
Mailing Address - City:MAHWAH
Mailing Address - State:NJ
Mailing Address - Zip Code:07430-2818
Mailing Address - Country:US
Mailing Address - Phone:908-251-4328
Mailing Address - Fax:
Practice Address - Street 1:26 MADISON AVE
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-7366
Practice Address - Country:US
Practice Address - Phone:908-251-4328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-25
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00899300101YP2500X, 101YP2500X
COLPC.0016451101YP2500X
CO0016451101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional