Basic Information
| Provider Information | |||||||||
| NPI: | 1073593828 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MAUST | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | MED LPCC-S | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1375 US HIGHWAY 42 SE | ||||||||
| Address2: | SUITE C | ||||||||
| City: | LONDON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 431409548 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7408458652 | ||||||||
| FaxNumber: | 6145030899 | ||||||||
| Practice Location | |||||||||
| Address1: | 1375 US HIGHWAY 42 SE | ||||||||
| Address2: | SUITE C | ||||||||
| City: | LONDON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 431409548 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7408458652 | ||||||||
| FaxNumber: | 6145030899 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/18/2006 | ||||||||
| LastUpdateDate: | 06/07/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | E-1444 | OH | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.