Provider Demographics
NPI:1184770455
Name:DANIEL, DANNY EUEL (LPC, LMFT)
Entity type:Individual
Prefix:MR
First Name:DANNY
Middle Name:EUEL
Last Name:DANIEL
Suffix:
Gender:M
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5335 REDDOCH DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-4611
Mailing Address - Country:US
Mailing Address - Phone:601-956-0606
Mailing Address - Fax:
Practice Address - Street 1:1855 LAKELAND DR STE P231
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4984
Practice Address - Country:US
Practice Address - Phone:601-366-6503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS0761101YP2500X
MST0198106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist