Provider Demographics
NPI:1265189872
Name:DELCOCO, DANIEL (MS)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:DELCOCO
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2560 HUNTINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22303-1447
Mailing Address - Country:US
Mailing Address - Phone:571-354-0465
Mailing Address - Fax:
Practice Address - Street 1:2560 HUNTINGTON AVE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22303-1447
Practice Address - Country:US
Practice Address - Phone:571-354-0465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-03
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health