Daniels, Larry E
Daniels, Larry E is an sole proprietor health care provider with primary practice located at 2301 Wrightsboro Rd , Augusta GA 30904-6219. He recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Cognitive & Behavioral, Behavioral Health & Social Service Providers / Family. Behavioral Health & Social Service Providers / Psychologist is his primary health care specialty. Daniels, Larry E can be contacted via phone (706) 733-7029.Contact Information
Primary practice address
2301 Wrightsboro Rd
Augusta GA 30904-6219
Phone: (706) 733-7029
Fax: (706) 733-1376
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PSY002223 | Georgia |
Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 831 | South Carolina |
Behavioral Health & Social Service Providers / Cognitive & Behavioral | 103TB0200X | PSY002223 | Georgia |
Behavioral Health & Social Service Providers / Family | 103TF0000X | PSY002223 | Georgia |
Behavioral Health & Social Service Providers / Psychologist | 103T00000X | PSY002223 | Georgia |
Profile Details
NPI number | 1104849215 |
---|---|
LBN Legal business name | Daniels, Larry E |
Credentials | PSY.D |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jul 26th, 2006 |
Last updated | Dec 1st, 2009 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1104849215 | NPPES |
South Carolina | MEDICAID | PS0268 | |
South Carolina | MEDICAID | 000801094C |
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