Individual
DANIELLE MCCORD MICKELONIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCMHC, LCAS
Contact information
Practice address
615 SHIPYARD BLVD, WILMINGTON, NC 28412-6431
(910) 343-0145
(910) 341-5779
Mailing address
615 SHIPYARD BLVD, WILMINGTON, NC 28412-6431
(910) 343-0145
(910) 341-5779
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-26121
NC
101YM0800X
Mental Health Counselor
15675
NC
101YM0800X
Mental Health Counselor
A15675
NC
101YP2500X
Professional Counselor
15675
NC
101YP2500X
Professional Counselor
Primary
A15675
NC
Other
Enumeration date
03/26/2020
Last updated
08/30/2022
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