Provider Demographics
NPI:1861993511
Name:KIM, DANIELLE P (LHMHC)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:P
Last Name:KIM
Suffix:
Gender:F
Credentials:LHMHC
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:MINTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4111E ROSE LAKE DR # 7888
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28217-2858
Mailing Address - Country:US
Mailing Address - Phone:828-278-8262
Mailing Address - Fax:
Practice Address - Street 1:4111E ROSE LAKE DR # 7888
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28217-2858
Practice Address - Country:US
Practice Address - Phone:828-278-8262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-27
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA13765101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional