Provider Demographics
NPI:1265588206
Name:DAGLE, DANIEL L (LPCC, LPC)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:L
Last Name:DAGLE
Suffix:
Gender:M
Credentials:LPCC, LPC
Other - Prefix:MR
Other - First Name:DANIEL
Other - Middle Name:LAWRENCE
Other - Last Name:DAGLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPCC
Mailing Address - Street 1:3751 DEL REY BOULEVARD
Mailing Address - Street 2:UHS MESILLA VALLEY HOSPITAL
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88012
Mailing Address - Country:US
Mailing Address - Phone:575-382-3500
Mailing Address - Fax:
Practice Address - Street 1:3751 DEL REY BOULEVARD
Practice Address - Street 2:UHS MESILLA VALLEY HOSPITAL
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88012
Practice Address - Country:US
Practice Address - Phone:575-382-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCCMH0191581101YP2500X
TX16564101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX16564OtherLPC LICENSE NUMBER
TX16564OtherLPC LICENSE NUMBER