Individual
DR. DANIEL LEE BANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
6825 PARKDALE PL STE C, INDIANAPOLIS, IN 46254-6602
(317) 981-5418
(317) 981-5429
Mailing address
6825 PARKDALE PL STE C, INDIANAPOLIS, IN 46254-6602
(317) 981-5418
(317) 981-5429
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
200400759A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000209316
BLUE CROSS/BLUE SHIELD
IN
01
—
066606
VALUE OPTIONS PROVIDER #
IN
01
—
113340000
MAGELLAN PIN #
IN
05
—
200383710A
—
IN
01
—
200450A
MEDICARE
—
01
—
2090807
CIGNA PROVIDER NUMBER
IN
Enumeration date
08/20/2006
Last updated
09/20/2018
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