Basic Information
| Provider Information | |||||||||
| NPI: | 1942962360 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BECKER | ||||||||
| FirstName: | DANIELLE | ||||||||
| MiddleName: | JOSIE | ||||||||
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| Credential: | BA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2909 GULF TO BAY BLVD APT F102 | ||||||||
| Address2: | |||||||||
| City: | CLEARWATER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337594283 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7273036841 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 8800 49TH ST N STE 106 | ||||||||
| Address2: | |||||||||
| City: | PINELLAS PARK | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337825332 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7275440044 | ||||||||
| FaxNumber: | 7275450125 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2021 | ||||||||
| LastUpdateDate: | 10/13/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/13/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.