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:
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Health care specialties

SpecialtyCodeLicense #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 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104849215 NPPES
South Carolina MEDICAID PS0268
South Carolina MEDICAID 000801094C

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